门静脉高压是肝硬化的直接后果，也是肝硬化的一种进行性并发症。
出血的发生可显著增加患者的发病率及死亡率。
非选择性β受体阻滞剂和（或）内镜套扎法可预防静脉曲张破裂出血的发生。
复苏治疗、血管活性药物或生长抑素类似物、内镜下套扎可用于控制急性出血。其他治疗还包括肝内门体静脉分流术和预防性使用抗生素。
内镜诊断和监测是处理食管胃底静脉曲张的重要方面。
食管静脉曲张是门静脉高压的并发症之一，表现为侧支血管扩张，常见于肝硬化。内镜下可见曲张静脉。在欧美地区，肝硬化主要由酒精性肝病引起。在世界范围内，乙型和丙型肝炎病毒感染为肝硬化的主要原因。[1]Alter MJ. Epidemiology of hepatitis B in Europe and worldwide. J Hepatol. 2003;39 Suppl 1:S64-9.
https://www.journal-of-hepatology.eu/article/S0168-8278(03)00141-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/14708680?tool=bestpractice.com
[2]Kim WR, Brown RS Jr, Terrault NA, et al. Burden of liver disease in the United States: summary of a workshop. Hepatology. 2002 Jul;36(1):227-42.
http://www.ncbi.nlm.nih.gov/pubmed/12085369?tool=bestpractice.com
一旦发生肝硬化，逐渐增加的肝静脉压力梯度和恶化的肝功能就可能导致食管静脉曲张形成。
食管静脉曲张破裂可引起致命性出血。曲张静脉的直径是其破裂出血最重要的预测因素，重度静脉曲张患者的首次出血风险最高（年发生率 15%）。[3]North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med. 1988 Oct 13;319(15):983-9.
http://www.ncbi.nlm.nih.gov/pubmed/3262200?tool=bestpractice.com
[4]Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med. 2010 Mar 4;362(9):823-32.
http://www.ncbi.nlm.nih.gov/pubmed/20200386?tool=bestpractice.com
失代偿性肝硬化(Child-Pugh B/C)和内镜下的红痕征也是食管胃底静脉曲张破裂出血的其他重要预测因素。[3]North Italian Endoscopic Club for the Study and Treatment of Esophageal Varices. Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study. N Engl J Med. 1988 Oct 13;319(15):983-9.
http://www.ncbi.nlm.nih.gov/pubmed/3262200?tool=bestpractice.com
[5]Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2017 Jan;65(1):310-35.
https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.28906
http://www.ncbi.nlm.nih.gov/pubmed/27786365?tool=bestpractice.com
