Oesophageal

Varices
Prof. Dr. Faisal Ghani
Siddiqui
faisalghani@lumhs.edu.pk

superficial
veins from

Oesophageal mucosa drain into

left gastric vein

which in turn drains into portal
vein

Management of Bleeding
Varices
Resuscitation
Diagnosis
Treatment

Resuscitation
Manage shock
Correct coagulopathy
Antibiotics

Diagnosis
Clinical
Laboratory
Oesophagogastroscopy

 Elevated Bilirubin
Albumin < 3 g/dl
Anaemia

Oesophagogastroscopy

Medical
Vasopressin, Terlipressin
Somatostatin

Mechanical
Balloon tamponade
Sengstaken-Blakemore tube
Minnesota tube

Interventional,
nonsurgical
Endoscopic Banding
Endoscopic Sclerotherapy

Surgical
Portocaval shunt
Esophageal transection
Liver transplantation

 in summary
when a person vomits
blood!