Volume N4  ·   Issue 02  ·  1978

Massive hemorrhage from ruptured es- ophagcal ancl gastric fiindus vurices is causcd mostly by late schistosomiasis or poslhc- patitis liver cirrhosis. Iti Lreatment is one of the challenging problems deserving serious attention in current surgical Vliictice. The resulLs of both nonsurgical and surgical treat- ment usccl in. the ptast W0re unsatisfactory. Among the nonsurgical mciaisures. blood trans- fusion and intravenoux pituitiin infusion are relativcly cffective in some cases with slighL bleeding. Bleedirig can be offoctively con_ trolled by baIloon uimponncIo ii the patient is cooperative and thi? triple lumc:n tube is properly positioncd. But the balloon js in- tolerable to some patients and in restless pre- comatous patients intubation is almost im— possible. MoreOVer, blecding may recur aiter extubation due to dislodgcmenli of the thrombus formed at the rupture site.