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!