Active bleeding of esophageal varices can be difficult to treat, it really represents a life-threatening condition when not treated, because just 50% of patients with acute variceal hemorrhage stop bleeding spontaneously.
Endoscopic therapy is currently the definitive treatment of choice for active variceal hemorrhage and it can be performed at the same time as diagnostic endoscopy at the bedside by virtually all trained endoscopists.
Band ligation is effective for achieving hemostasis and for prevention of early rebleeding.
The following images correspond to a case of active variceal bleeding wich was treated with endoscopic ligation:
Courtesy of Dr. Mariana Herrera Guerrero
What?
Is that can be true?
One of my colleagues investigated using a circular stapler, applied via laparotomy to the area of bleeding, to interrupt venous flow. He said his residents came to refer to it as Dr. —‘s operation of death.