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February 16, 1946


Author Affiliations

Dallas, Texas

From the Division of Gastroenterology, Department of Medicine, Southwestern Medical College.

JAMA. 1946;130(7):384-386. doi:10.1001/jama.1946.02870070004002

It is well known that recurring massive hemorrhage ultimately resulting in death often occurs in the patient who has untreated esophageal varices. As seen by x-ray examination and esophagoscopy, the bulbous venous projections into the esophageal lumen are daily subject to trauma from the swallowed bolus of food. Ulceration and rupture result in massive blood loss. Esophageal varices appear to serve no useful purpose that cannot be served by other and nonvulnerable anastomoses between the portal and systemic venous circulations. Our experience is that obliteration of these veins results in no appreciable unfavorable effects but rather that clinical improvement occurs soon after prevention of blood loss from the ruptured varix.

Experimental animals and other species than man have not provided the clinical syndrome in which the esophageal varix appears. Injection treatment had for years been considered, but it remained for two physicians, Paul Frenckner and Clarence Crafoord1 of Stockholm,

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