A. Oesophageal transection
B. Endoscopic Balloon Tamponade
D. Banding of esophageal varices
Ans:D. Banding of esophageal varices.
- Emergency gastroscopy and banding of esophageal varices (blue rubber bands) procedure is shown in the image.
- Most common cause of this condition: Cirrhosis (alcohol and hepatitis B or C).
- Factors predictive of bleeding: Size of varices (directly proportionate to the vessel wall tension), red wheal markings on the varices (from decreased wall thickness), severity of liver disease and persistent alcohol abuse.
- Bleeding can be stopped by Injection sclerotherapy or balloon tamponade using a Sengstaken Blakemore tube.
- 70% of patients re-bleed within the first year. Beta-blockers reduce this risk by half. With variceal treatment, the incidence is reduced by a further half.
- Other options which can be considered if endoscopic treatments fail:Transjugular Intrahepatic Portosystemic Shunting (TIPS), surgical shunt (partial/selective) or oesophageal transection.