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Topics:
Gastroenterology • General Hepatology
What is your approach to secondary prophylaxis and post-discharge planning after an acute esophageal variceal bleed in a patient with ongoing alcohol use disorder and major social barriers (uninsured, homeless)?
Do you consider early TIPS?
Longer stay to repeat EGD before discharge?
How do you help ensure they get their Carvedilol/NSBB long-term?
Answer from: at Academic Institution
Obviously these questions are moot in the setting of an acute variceal bleeding when a life saving TIPS becomes necessary; we then deal with these issues afterwards.We frankly go as far as we can with medical/endoscopic therapy before considering TIPS as an option for repeated bleeding episodes, whi...
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