Following resuscitation, a patient with bleeding oesophageal varices should be treated initially with ?
Ans. is 'a' i.e., Sclerotherapy Though both Endoscopic scleherapy and ligation can be used for fuher management of esophageal varices, band ligation is the procedure of choice. Harrison writes -"The approach to patients once they have had a variceal bleed is first to treat the acute bleed, which can be life-threatening, and then to prevent fuher bleeding. Prevention of fuher bleeding is usually accomplished with repeated variceal band ligation until varices are obliterated." Maingot's writes- "The current standard for endoscopic therapy for esophageal varices is endoscopic banding. This has largely replaced endoscopic sclerotherapy because it has fewer side effects, obliterates varices faster, and, with new technology, can be easily applied.- Also know: Cirrhotic patients with variceal bleeding have a high risk of developing bacterial infections, which are associated with ro rebleeding and a higher moality rate. The use of sho-term prophylactic antibiotics has been shown both to decrease the rate of bacterial infections and to increase survival.
Selerotherapy
Sangstaken Blackmore tube
Propranolol
Surgery