Acute bleeding varices: a five-year prospective evaluation of tamponade and sclerotherapy.

Abstract:

:In a five-year study of massive upper gastrointestinal hemorrhage, 143 patients had esophageal varices diagnosed on emergency endoscopic examination. Seventy-one patients had active bleeding from varices and required Sengstaken tube tamponade during at least one hospital admission. The remaining patients included 33 with variceal bleeding which had stopped and 39 who were bleeding from another source. Sixty-six of the former group of 71 patients were referred for emergency injection sclerotherapy. These 66 patients were followed prospectively to August 1980, and had 137 episodes of endoscopically proven variceal bleeding requiring Sengstaken tube control followed by injection sclerotherapy during 93 separate hospital admissions. Definitive control of hemorrhage was achieved in 95% the patients admitted to the hospital (single injection 70%; two or three injections 22%). The death rate per hospital admission was 28%. No patient died of continued variceal bleeding, and exsanguinating variceal hemorrhage no longer poses a major problem at our hospital. The combined use of initial Sengstaken tube tamponade followed by injection sclerotherapy has simplified emergency treatment in the group of patients who continue to bleed actively from esophageal varices, despite initial conservative treatment.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Terblanche J,Yakoob HI,Bornman PC,Stiegmann GV,Bane R,Jonker M,Wright J,Kirsch R

doi

10.1097/00000658-198110000-00015

subject

Has Abstract

pub_date

1981-10-01 00:00:00

pages

521-30

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

194

pub_type

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