The development of portal hypertension in cirrhosis is associated with a multitude of diagnoses, most commonly ascites, gastroesophageal varices (GEV), and hepatic en- cephalopathy. Nearly half of the patients with cirrhosis have GEV at the time of diagnosis, and 5% to 15% of the patients experience esophageal varices each year. 1 Guidelines recommend noncardioselective b-blockers or endoscopic variceal ligation (EVL). 2 Recurrent bleeding after initially successful EVL occurs in 20% to 60% of patients, most commonly from the ulcers, and is associated with 20% to 50% mortality. 3
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