Bleeding Esophageal Varices

exp date isn't null, but text field is

Esophageal varices are collateral veins within the wall of the esophagus that project directly into the  lumen. Acute variceal bleeding is a fatal complication in patients with liver cirrhosis. In patients with  decompensated  liver  cirrhosis  accompanied  by  ascites  or  hepatic  encephalopathy,  acute  variceal  bleeding is associated with a high mortality rate. 

Pharmacological Treatment

S:  octreotide  (SC)  50–100µg  8hourly  for  3days  (infusion  50µg/hour  for  72hours  up  to 5days) 

OR  

S: terlipressin: Adult (body weight up to 50 kg): Initially 2 mg every 4 hours until bleeding controlled, then reduced to 1 mg every 4 hours if required, maximum duration 48 hours.  Adult (body weight 50 kg and above): Initially 2 mg every 4 hours until bleeding controlled,  reduced if not tolerated to 1 mg every 4 hours, maximum duration 48 hours 

AND 

Band ligation of beeding esophageal varices (EVL); 3 – 6 shoots per session. 

OR 

Sclerotherapy (Histo Acryl Glue Inj. 5 %;( mixed with Lipiodol at a ratio 1:1) Ethanolamine oleate 5%); given 2 -5ml per varix up to 20ml per session. 

AND 

B: ceftriaxone (IV) 1g 24hourly for 7days 

Note: Blood transfusion (PRBC, PLT concentrates and FFP) when required.