Intraesophageal Venous Tamponage

Bleeding from the esophagus still constitutes a frequent cause of death in cirrhosis of the liver, despite the numerous and varied procedures devised for its prevention and cure. The methods employed heretofore may be divided into direct and indirect procedures. The former include surgical ligation of the contributory veins or their ligation and subsequent injection with sclerosing agents, and also the direct injection of the varices or their cauterization through the esophagoscope. Inthe indirect categories are the time-honored Eck fistula recently revived by Blalock, and omentopexy, and the newer "shunting" procedures involving anastomoses of the splenic to the left renal vein. Confronted recently with prolonged, uncontrollable and what was finally believed to be terminal bleeding from the esophagus in a case of cirrhosis of the liver, we successfully employed the principle of internal venous tamponage. In our patient, the site of the bleeding was clearly visualized through the esophagoscope,