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Balloon tamponade vs. endoscopic sclerotherapy in the management of active variceal hemorrhage
Author(s) -
Terés Josep
Publication year - 1989
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840100328
Subject(s) - balloon tamponade , sclerotherapy , medicine , balloon , tamponade , gastric varices , surgery , portal hypertension , cirrhosis
Sengstaken‐Blakemore tamponade is used for the initial control of bleeding esophageal varices (BEV), although it is known to be potentially dangerous. Sclerotherapy has been shown to be effective in the treatment of BEV. This trial has been designed to evaluate comparatively the effectiveness of both procedures in the initial control of the hemorrhage. Forty‐three patients with BEV were included in the trial. Twenty patients (group SB) were treated by tamponade. Twenty‐three patients (group ST) were treated by sclerotherapy by means of a simple technique. During the first 24 hours, hemostasis was obtained in 16 of the SB patients and in all 23 of the ST patients (p < 0.05). At seven days, nine SB patients and 19 ST patients were free of hemorrhagic relapse (p < 0.05). By stratifying in relation to hepatic failure, the difference was greater (p < 0.005) if patients with Child's A classification were excluded. It is concluded that sclerotherapy should be undertaken in almost every instance at the same moment that diagnosis is made, bypassing the intermediate step of tamponade.