Current Practice DISEASE OF THE DIGESTIVE SYSTEM Management of Bleeding Oesophageal Varices

Patients with bleeding oesophageal varices die from exsanguination or liver failure or a combination of these factors. The development of liver failure is inevitable if bleeding is allowed to continue, and the first aim of treatment must be to stop haemorrhage by the fastest and simplest method available. Unfortunately bleeding tends to recur unless the portal venous pressure can be permanently lowered ; but in practice the timing and choice of correct operation are difficult. Throughout the care of these patients medical and surgical therapy are closely linked, and the importance of combined consultation of physician and surgeon with formulation of a definite plan for each patient canxiot be overstressed.