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New AASLD Guidelines Ask Us to Reconsider How We View Bleeding Risk in Cirrhosis
David A. Johnson, MD
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March 04, 2021
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This transcript has been edited for clarity.
Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia.
Kudos to the American Association for the Study of Liver Diseases (AASLD) for their latest expert consensus document. Among the several topics covered in these 48-page guidelines are vascular anomalies such as portal vein and hepatic vein thrombosis, and hepatic and splenic aneurysms. However, today I wanted to highlight for you the section dealing with coagulation management in patients with cirrhosis, including how it relates to interventions we commonly deal with as gastroenterologists, such as endoscopic or surgical procedures.
Reconsidering Cirrhosis-Related Bleeding
It would be an understatement to say that patients with cirrhosis have multiple alterations in their hemostatic system. It needs to be better understood, however, that there are hemostatic changes promoting both bleeding and clotting that occur simultaneously in any given individual patient. These changes may in fact counteract each other. |
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发表于 2021-3-5 18:59