Nonendoscopic management of variceal bleeding

What is the nonendoscopic management of variceal bleeding? 

If a variceal etiologic factor is suspected, octreotide bolus (50 mcg) with subsequent infusion (50 mcg/h) should be initiated to decrease portal pressures and ongoing bleeding. Antibiotics (typically a fluoroquinolone or ceftriaxone if there is a high local prevalence of quinolone-resistant organisms) should be given for 7 days in all patients with cirrhosis who present with UGI bleeding (variceal or nonvariceal) to decrease the risk of rebleeding, infection, and mortality. Patients with cirrhosis are more likely to require correction of coagulopathy and thrombocytopenia, and may develop hepatic encephalopathy, which can be treated with lactulose or rifaximin.


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