Risk indicators of variceal bleeding.

Variceal bleeding is a catastrophic event in the history of liver cirrhotics. However, in more than half of the patients it never occurs. Thus, measures to prevent bleeding should be undertaken only in patients at the highest risk of bleeding. Risk indicators should help to select those patients. Hemodynamic and endoscopic parameters as well as liver function and coagulation status and the patient's history have been studied in relation to the bleeding incidence. The following parameters are correlated with an increased bleeding risk: The first year after diagnosis of varices, a positive history of variceal bleeding, presence of varices with large diameters, high blood pressures or a red colour sign, concomitant gastric varices or development of a liver cell carcinoma. Other parameters may be of less importance for the occurrence of variceal bleeding.