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BLEEDING OESOPHAGEAL VARICES
Author(s) -
STEPHEN MICHAEL,
LITTLE J. MILES
Publication year - 1978
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1978.tb07295.x
Subject(s) - medicine , hepatorenal syndrome , varices , portal hypertension , conservative management , surgery , shunt (medical) , cirrhosis , decompression , natural history , conservative treatment , mortality rate , general surgery , ascites
At the Royal Prince Alfred Hospital, most patients with bleeding varices have been poor‐risk alcoholics. A high proportion were receiving a State pension. The early mortality due to bleeding varices was 53%. This figure comprised a 60% mortality following conservative management and 40% after urgent shunt. All patients having urgent operations which were not portal decompression died. No patient who had an elective shunt died. In a mean follow‐up period of 15.4 months, a further 14% of survivors died. No form of conservative management appeared to have much effect on the natural history of the bleeding. A blood replacement of more than five litres indicated that spontaneous cessation of haemorrhage was unlikely. Shunt operations usually controlled haemorrhage, but hepatorenal failure was common after the urgent shunts. The cost of operation was greater than that of conservative management, but in neither case was it considered excessive.