This review article in the New England Journal of Medicine covers recent evidence on the management of varices and variceal bleeding in liver cirrhosis. Topic headings are:
• Natural history and epidemiology
• Pathophysiology and pathophysiological bases of therapy
• Therapies that reduce portal pressure
• Local therapies without portal pressure–reducing effects
• Risk stratification for patients with portal hypertension
• Prevention of varices and a first variceal haemorrhage
• Treatment of acute variceal haemorrhage
• Prevention of recurrent variceal haemorrhage
• Special situations for which there is limited or no evidence
• Portal hypertensive gastropathy
• Associated portal-vein thrombosis