Oesophageal varices secondary to portal hypertension is one of the complications of alcoholic liver cirrhosis. Without treatment, recurrent haemorrhage occurs in almost all patients who survive the initial bleeding episode, often within a year. In addition, these agents further reduce portal pressure by venodilation. Once the patient is haemodynamically stable, urgent endoscopy should be performed. In patients who continue to actively bleed, balloon tamponade may be used as a temporary measure until more definitive therapy can be undertaken.
Vasoactive drugs contribute to control of bleeding and decrease portal pressure.
The rate of early rebleeding may also be reduced following sclerotherapy. Injection techniques can be either intravariceal or paravariceal, or a combination of the two. Although, rebleeding does occur, it appears to be less common following sclerotherapy using adhesives than sclerosants. In addition, there appears to be a lower incidence of early rebleeding and reduced transfusion requirements using combined therapy. However, endoscopic ligation may require more technical skill and the procedure may take longer than sclerotherapy.