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Controversies concerning treatment of upper digestive hemorrhages in portal hypertension of cirrhotic patients our experience



Controversies concerning treatment of upper digestive hemorrhages in portal hypertension of cirrhotic patients our experience



Revista de Chirurgie Oncologie Radiologie O R L Oftalmologie Stomatologie Seria Chirurgie 35(1): 51-58



An analysis is made, of a series of 681 patients presenting with upper digestion haemorrhages in the course of portal hypertension that had developed on a background of cirrhosis of the liver. All the patients were treated as emergencies in our clinic. The results are compound with those reported in a previous series of 482 caes. The authors discuss the attitude to be followed, and their results. They stress the necessity for an intensive medical therapy in the initial stage (gastric control probe with continuous alkaline washing, or a Blakemore probe in cases of failure; re-establishing the blood volume; perfusion of vasopressine; haemostatics; rapid evacuation of blood from the intestine). The surgical procedure should be simple, fast, non-aggressive, and should attempt to reduce the blood flow to the oesophagus without suppressing it completely. The surgical procedure is indicated only if the conservative treatment fails, and with great care, in the advanced stages of the disease, as well as in patients with multiple affection or in aged subjects.

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