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Endoscopy in the Setting of Coagulation Abnormalities in the Patient with Liver Disease
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Endoscopy in the Setting of Coagulation Abnormalities in the Patient with Liver Disease
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Endoscopy in the Setting of Coagulation Abnormalities in the Patient with Liver Disease
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Book Chapter
Endoscopy in the Setting of Coagulation Abnormalities in the Patient with Liver Disease
2017
Overview
It is increasingly recognized that patients with chronic liver disease have a reset hemostatic mechanism. This includes risks of both spontaneous and procedural bleeding, as well as inappropriate clotting, such as peripheral or portal vein thrombosis and small vessel thrombotic disease, possibly leading to hepatic parenchymal extinction and ultimately organ atrophy. Moreover, the conventional method of monitoring bleeding risk with prothrombin time/international normalized ratio is becoming recognized as an unreliable measure of bleeding (or clotting) risk in these patients. Herein, the coagulation mechanisms of patients with chronic liver disease and pitfalls of current practice are highlighted. A strategy to better identify and manage this challenging patient population in the setting of endoscopic interventions is proposed.
Publisher
John Wiley & Sons, Incorporated,John Wiley & Sons, Ltd
Subject
ISBN
9781118660874, 1118660870
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