Fibreoptic endoscopy and the use of the Sengstaken tube in acute gastrointestinal haemorrhage in patients with portal hypertension and varices.

Efficacy of Oral Propranolol and Injection Sclerotherapy in the Long-Term Management of Variceal Bleeding

“…No single most effective method to control acute bleeding has yet been defined. Sengstaken Blakemore tube is effective in 70% cases [ 1 ] while non-selective B blocker propranolol in doses that reduce the resting pulse rate by 25% has been found effective in the pre vention of rebleeding in 79-87% cases at 1 and 2 years [2][3][4][5][6]. but same results were not supported by others [7], Sclerotherapy con trols active bleeding in 79-100% cases [8][9][10] and has a mortality of 8-33% which is directly related to the hepatic reserve.…”

Endoscopic findings of bleeding esophageal varices and experimental study.

“…Conventionally, it has been reported that the rupture of esophageal varices occurs with high incidences (67% by Novis et al 1976; 72% by Terblanche et al 1979), and once bleeding occurs it sometimes causes fetal massive bleeding. However, according to the experiences of our active application of emergency endoscopy since 1977, the incidence of bleeding from varix was unexpectedly low even in the cases with severe esophageal varices, and that the bleeding source was often the esophageal and/or gastric erosions, gastric or duodenal ulcers.…”

The management of bleeding esophageal varices

“…Gastritis rather than varices will be the culprit a third of the time. 8 Emergency angiography is not required if the diagnosis is secure and if bleeding is controlled. If bleeding persists, angiography is carried out to investigate the possibilities of hemorrhagic gastritis (which may sometimes be controlled by intraarterial infusion of vasopressin) and of bleeding peptic ulcer (which may be amenable to arterial embolization with polyvinyl alcohol or Gianturco-Wallace coils).…”