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1 The Korean Journal of Gastrointestinal Endoscopy Room C .. Management of Esophageal Variceal Bleeding Soon Koo Baik, , Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea 1 3 , 6 12 . 7.. 24 80% , 2.. 2 19 40% 1) : . 1-3.. F1 ( , 8 g/dl ), F2 ( ), F3 ( ) , . , . Li ( ), Lm ( , . 1,3,4. ), Ls ( ) , . Cw ( ), Cb ( ) . RCS (Red Color , . 3-6. Sign, / ) . , ( 7 ) . norflo- 50% xacin (400 mg bid) ciprofloxacin . , , quinolone ceftriaxone (1. 1,7,8 1,2,7. 2 30 40% . , g/day) . , .. terlipressin somatostatin .. Terlipressin 2 mg 4 . , , 1 mg 4. 1.. Somatostatin 250 mcg . - 5% 250 mcg . 1,3. , . 2 3 , 2) : . Child A, B 1 2 12 . 1,7.. Child C (Endoscopic sclerotherapy), . ( , , (Endoscopic variceal ligation:EVL), cyanoa- ) crylate, fibrin thrombin (tissue 1,5,7.

2 Adhesives) , . (maximal tolerated doses) , . 1,2. , . 2 4 , (1) : . 176 The Korean Journal of Gastrointestinal Endoscopy .. 70 100%, 9 39% .. , . 3.. , , , , , , . 90% , 2 3,6.. 20% .. N-butyl-cyanoacrylate, isobutyl-2-cyanoacrylate . (2) : .. , , .. sodium morrhuate, 5% ethanolamine oleate .. , , . 1 2 . 3.. 1 3 3 6 , (lipiodol) , . Figure 1.. Vol. 41 (Suppl 1), 2010 (176-178) 177.. 7.. Child C . 3) : , . 10 20% . , , HVPG .. (hepatic venous pressure gradient) 20 mmHg , Hb 1,9-11.. 8 g/dl .. , (Sengstaken- terlipressin somatostatin . Blackemore tube) (TIPS: tran- , .. sjugular intrahepatic portosystemic shunt) , .. , 80% . , . , 24 , . , 24 .. 1.. TIPS . , 90% , .. TIPS . 2.. 1. de Franchis R. Evolving Consensus in Portal Hypertension Report of the Baveno IV Consensus Workshop on metho- 3.

3 Dology of diagnosis and therapy in portal hypertension. J He- patol 2005;43:167-176. 2. Garcia-Tsao G, Sanyal AJ, Grace ND, Carey W. Prevention , 6 and management of gastroesophageal varices and variceal he- 5 morrhage in cirrhosis. Hepatology 2007;46:922-938.. 3.. , 2008;37(suppl 1):152S-157S.. 4.. 55 25% 2008;37(suppl 1):158S-161S. 9,10 5.. , 80 240 mg .. 2008;37(suppl 1):163S-170S. 6. , . , . , . 2008;37(suppl 1):171S-176S. 14 30 7.. 2008;. , 3 6 37(suppl 1):177S-187S.. 8. Kim MY, Baik SK, Suk KT, et al. Measurement of hepatic venous pressure gradient in liver cirrhosis: Relationship with 5 the status of cirrhosis, varices, and ascites in Korea. Korean J.. Hepatology 2008;14:150-158. TIPS 9. Suk KT, Kim MY, Park DH, et al. Effect of propranolol on portal pressure and systemic hemodynamics in patients with liver cirrhosis and portal hypertension: a prospective study.

4 7 Gut Liver 2007;1:159-164.. 10. Baik SK. Pharmacological therapy of portal hypertension -fo- cused on Korean data-. Korean J Gastroenterol 2005;45: (Fig. 1). 381-386. 11. Baik SK. Assessment and Current Treatment of Portal Hy- pertension. Korean J Hepatol 2005;11:211-217.. 178 The Korean Journal of Gastrointestinal Endoscopy