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Document Outline - Austrian consensus on the definition and treatment of portal hypertension and its complications (Bil
- Zusammenfassung
- Summary
- Introduction/background
- Criteria and definition of portal hypertension
- Approach to the diagnosis of portal hypertension
- Preprimary prophylaxis of variceal bleeding
- Background
- Recommendation
- Primary prophylaxis
- Indications for medical treatment and follow-up endoscopy
- Monitoring of beta-blockade
- Choice of primary prophylaxis for patients with large varices
- Combination of treatments for primary prophylaxis
- Acute variceal bleeding and rebleeding: definition and prognostic value
- Definition of acute variceal bleeding
- Failure to control acute bleeding (based on international consensus)
- Failure of secondary prophylaxis (every variceal bleeding after initiation of secondary prophylaxis)
- Treatment of acute variceal bleeding (AVB)
- Prerequisites for therapy (III)
- Time management of endoscopic treatment
- Blood volume restitution
- Antibiotic prophylaxis to prevent bacterial infections/spontaneous bacterial peritonitis
- Prevention/therapy of hepatic encephalopathy
- Assessment of prognosis
- Use of balloon tamponade
- Pharmacological treatment
- Recommended drug doses
- Endoscopic therapy of esophageal variceal bleeding
- Early TIPS-placement
- Prevention of variceal rebleeding (secondary prophylaxis)
- Standard therapy
- Treatment of patients with contraindications to beta-blockers or combination drug therapy
- Treatment of low-risk patients (early stage liver disease, sufficient tolerance of bleeding) with failure of secondary prophylaxis
- Treatment for high-risk patients with failure of medical/endoscopic therapy in the prophylaxis of rebleeding
- Portal hypertensive gastropathy (PHG), gastric antral vascular ectasia (GAVE)
- Definitions
- Treatment of acute PHG bleeding
- Treatment of chronic PHG bleeding
- Treatment of GAVE bleeding
- Gastric varices
- Definitions
- For therapy of bleeding gastric varices, the following approaches can be used
- For long-term therapy of fundal varices, there are no established and prospectively evaluated therapies. Potential candidate therapies include
- Management of ascites
- Diagnostic approach in patients with ascites
- Therapy of uncomplicated ascites
- Refractory ascites
- Spontaneous bacterial peritonitis (SBP)
- Definition and management of SBP
- Long-term prophylaxis of SBP
- Transjugular intrahepatic portosystemic shunt (TIPS) for therapy of portal hypertension [3]
- General suppositions for TIPS placement
- TIPS for variceal bleeding
- TIPS in acute variceal bleeding
- TIPS for prophylaxis of variceal bleeding
- TIPS for refractory ascites (III)
- TIPS for other indications
- Hepatorenal syndrome (HRS)
- Diagnosis of HRS
- Management, general measures
- Specific treatment for HRS
- TIPS in HRS
- Role of renal replacement therapy and artificial liver support systems
- Liver transplantation
- Prevention of HRS
- Management of vascular liver disease
- Epidemiology
- Pathophysiology
- Diagnosis
- Management of noncirrhotic portal hypertension
- Hepato-pulmonary vascular disorders
- Portopulmonary hypertension
- Definition
- Staging of severity [2]
- Diagnosis
- Therapy
- Hepatopulmonary syndrome
- Definition
- Staging of severity
- Diagnosis
- Therapy
- Appendix
- References
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