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Oesophageal Varices
Prof. Dr. Faisal Ghani
Siddiquifaisalghani@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 summarywhen a person vomits
blood!
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