Oesophageal Varices

Question 1

What is the acute treatment of varceal haemorrhage?

Answer 1

1. ABC
2. Correct clotting: FFP or Vitamin K
3. Vasoactive agents: Terlipressin.
4. Prophylactic antibiotics - Quinolones.
5. Endoscopy: band ligation.
6. Sengstaken-Blakemore tube if uncontrolled haemorrhage.
7. TIPPS (Transjugular Intrahepatic Portosystemic Shunt) if all fails.

Question 2

What is the prophylaxis treatment of variceal haemorrhages?

Answer 2

1. Propranolol - reduces rebleeding & mortality.
2. EVL ( Endoscopic Variceal Band Ligation).
   
   1. PPI to prevent ulceration.