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Revista médica de Chile

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VARGAS T, Ling et al. Management of bleeding esophageal varices in public and private institutions in Chile. Rev. méd. Chile [online]. 2008, vol.136, n.7, pp.837-843. ISSN 0034-9887.

Background: The better treatment modalities for bleeding esophageal varices have improved the prognosis of cirrhosis. Aim: To inquire about diagnostic and treatment modalities for esophageal bleeding in Chile. Material and methods: An enquiry about diagnosis and treatment of esophageal bleeding was designed and electronically sent to public and prívate health institutions that could admit patients and were located in cides with more than 100,000 inhabitants. Results: The enquiry was answered by 31 of 35 public and 17 of 19 prívate health institutionis that were consulted. Emergency endoscopy was available in 6 of 27 public and in the 16 private institutionis that had an emergency room. Rubber band ¡igation was available in 16 public (52%) and in all prívate institutions. Cyanoacrylate injections were done in 10 public (32%) and 11 (65%) prívate institutions. No public institution instaUed transjugular intrahepatic portosystemic shunts, but 8 had occasional access to this technique. This procedure was done in 7 (41%) private institutions and all had access to it. Surgical treatment was feasible in 20 public (65%) and all prívate institutions. Prímary prophylaxis was done in 18 public (58%) and 14 prívate (82%) institutions. Secondary prophylaxis was carried out in 26 public (84%) and 16 prívate (94%) institutions. Conclusions: Public health institutions have poor access to adequate diagnostic and treatment methods for esophageal bleeding. The prímary and secondary prophylaxis of esophageal varices must be improved in both types of institutions

Keywords : Cyanoacrylates; Esophageal and gastric varices; Gastrointestinal hemorrhage.

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