Knowledge Portal
Portal-hypertensive bleeding
Acute variceal haemorrhage requires coordinated resuscitation and haemostasis rather than transfusion alone. Core management combines a restrictive red-cell strategy, vasoactive treatment, antibiotic prophylaxis and urgent endoscopy. Early identification of patients likely to benefit from pre-emptive TIPS is increasingly important, while refractory bleeding requires familiarity with temporary bridge therapies and rapid access to interventional radiology or transplantation expertise.
Key information
Guidelines and position statements
Relevant clinical practice guidelines, practice guidance, consensus statements and position papers from professional bodies and expert groups.
AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis
AASLD · practice guidance · 2024
Current AASLD guidance spanning prevention, acute variceal haemorrhage, pre-emptive TIPS and secondary prophylaxis.
Open resource →Baveno VII – Renewing consensus in portal hypertension
Baveno VII Faculty · consensus statement · 2022
International consensus statements covering clinically significant portal hypertension, acute bleeding and prevention of further decompensation.
Open resource →Further context
Other useful resources
Selected review articles, practical explainers, expert discussions, reference sites and e-learning from established providers.
An Update on the Management of Acute Variceal Bleeding: A Narrative Review
Gandhi P, et al. Journal of Intensive Care Medicine. 2026; online ahead of print.
The most recent ICU-facing narrative review in this selection.
Open resource →Management of acute variceal bleeding
Mohanty A, Garcia-Tsao G. Clinical Liver Disease. 2024;23(1):e0176.
A concise open-access review with clear algorithms for oesophageal and gastric variceal bleeding.
Open resource →Comprehensive approach to esophageal variceal bleeding: From prevention to treatment
Singh S, et al. World Journal of Gastroenterology. 2024;30(43):4602–4608.
A readable overview that links prevention, acute treatment and secondary prophylaxis.
Open resource →Variceal Haemorrhage
Critical Care Reviews · curated review collection · updated 2026
A free, maintained collection arranged around general management and therapies.
Open resource →Quick Tips: Esophageal Varices
AASLD Liver Fellow Network · infographic
A compact visual summary of acute oesophageal variceal bleeding management.
Open resource →Transjugular intrahepatic portosystemic shunt (TIPS)
Deranged Physiology · ICU revision chapter · updated 2025
A detailed explanation of TIPS indications, technique and complications.
Open resource →Endoscopic Management of Variceal Bleeding: Outdated or Evolving Beyond Tradition?
EASL Studio · expert discussion
A discussion of endoscopic innovation, interventional radiology and high-risk gastric varices.
Open resource →