Ligation of Esophageal Varices by the Transabdominal Route

Abstract

THE high mortality among patients who bleed from esophageal varices is well established. Ninety per cent of these patients have a coexisting cirrhosis of the liver as a cause of their portal hypertension and their varices. Approximately two thirds die at the time of their hemorrhage.¹ Stopping the hemorrhage is essential not only because of the danger of exsanguination but also to avoid the metabolic disturbance that follows the absorption of large amounts of blood in the intestine. Many patients exhibit encephalopathies often culminating in coma during bleeding, and their deaths can often be attributed to this complication.² Hepatic coma . . .