May 1982

Emergency Transumbilical Embolization of Bleeding Esophageal Varices

Author Affiliations

From the Departments of Surgery (Drs Tauber, Baker, and Nyhus), Medicine (Drs Winter and Layden), and Radiology (Dr Spigos), University of Illinois College of Medicine, Chicago.

Arch Surg. 1982;117(5):624-629. doi:10.1001/archsurg.1982.01380290074013

• Eight patients had major hemorrhage from esophageal varices; in seven, one or two embolizations of the coronary and short gastric veins resulted in cessation of hemorrhage. This procedure can be used in patients with massive ascites, severe coagulopathy, or profound liver failure, as the access route through the dilated umbilical vein can be reached via a supraumbilical incision done with the patient under local anesthesia. All patients died; two deaths were attributable to complications of the procedure, the other six to the severity of the cirrhosis. Sclerotherapy may be combined with coronary vein embolization, but the risk of esophageal perforation may be greater than with sclerotherapy alone.

(Arch Surg 1982;117:624-629)