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June 1966

Bleeding Esophagogastric Varices: An Endoscopic Study of 50 Cases

Author Affiliations

From the Gastroenterology Section of the Medical Service, Veterans Administration Hospital, Long Beach.

Arch Surg. 1966;92(6):944-947. doi:10.1001/archsurg.1966.01320240132029

HEMORRHAGE from ruptured esophagogastric varices is a serious complication of portal venous obstruction and portal hypertension. Improvements in nonsurgical techniques have provided fairly effective methods for the management and control of variceal bleeding, while surgical portasystemic venous shunting procedures have been developed to decompress the varices and prevent future hemorrhage. These therapeutic methods, however, have specific application and are not devoid of hazards. Since upper gastrointestinal hemorrhage in patients having large and extensive esophagogastric varices may originate from sources other than the varices, it is mandatory that whenever possible, a variceal bleeding site be accurately established prior to embarking on a course of therapy designed to control bleeding from this origin. Combined esophagoscopic and gastroscopic examination, performed during the period of active bleeding, enables the examiner to follow the blood to its source and is the most reliable diagnostic method available for detecting the bleeding lesion.1,2 The safety of