Treatment of Chronic Liver Failure in Liver Cirrhosis with Acute Bleeding from Cardiofundal Gastric Varices

Acute haemorrhage from cardiofundal gastric varices — classified as gastro-oesophageal varices type 2 (GOV2) or isolated gastric varices type 1 (IGV1) — in a patient with liver cirrhosis is a distinct and serious complication of chronic liver failure that requires a targeted, evidence-based response.

Clinical scenario: Patients with liver cirrhosis presenting with acute bleeding from cardiofundal gastric varices (GOV2 or IGV1) represent a specific sub-population within chronic liver failure. The variceal type and the underlying cirrhotic context together define the haemostatic approach.

Approach Overview

Medical management follows the same principles used in acute oesophageal variceal haemorrhage. Alongside medical stabilisation, endoscopic cyanoacrylate injection is the recommended haemostatic technique for cardiofundal varices of this classification.

The full regimen — including all components, sequencing, and clinical decision points — is available in the complete protocol.

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References

DOI: 10.1016/j.jhep.2018.03.024

Acute gastric VH should be treated medically, like oesophageal VH (I;1). Cyanoacrylate is the recommended endoscopic haemostatic treatment for cardiofundal varices (gastro-oesophageal varices type 2 or isolated gastric varices type 1) (I;2).

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