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March 1974

Control of Portal Hypertension: Selective Mesenteric Arterial Infusion of Vasopressin

Author Affiliations

From the Department of Surgery, Graduate Hospital of the University of Pennsylvania, Philadelphia; and Harvard School of Medicine, Massachusetts General Hospital, Boston.

Arch Surg. 1974;108(3):342-347. doi:10.1001/archsurg.1974.01350270072013

Between 1968 and 1973, of 41 patients with bleeding esophageal varices who were treated with selective superior mesenteric arterial infusion of vasopressin, 40 responded. Eighteen had shunt surgery, two of whom died. All of the other 23 died. Of 46 patients not treated by posterior pituitary extract (Pituitrin) in the same period, 39 died. Furthermore, mortality of the group treated with pituitary extract was lower than that of a group who bled before treatment with pituitary extract was available. The recommended technique of using the superior mesenteric artery and angiographic control must be strictly followed. If this is done, it can be counted on to convert an emergency situation to an elective one, which is more favorable for operation.