Efficacy of Combine Octreotide infusion and Endoscopic Variceal Sclerotherapy in Controlling of Acute Variceal Haemorrhage.

Abstract

Objectives: To determine the efficacy of Octreotide infusion in combination with Esophageal Variceal Sclerotherapy in controlling variceal hemorrhage and preventing early rebleed. Design; It is prospective observational case series. Place and Duration of Study: The study was conducted at Sheikh Zayed Hospital Hamza Medicare Rahim Yar Khan between January 1997 and December 2004. Patients and Methods: 580 patients presenting with acute variceal hemorrhage were detected among 892 patients presented with upper gastrointestinal bleeding. They were managed with combination of Octreotide infusion 25mg/hour at presentation with other resuscitative measures. Endoscopic Variceal Sclerotherapy was performed within 24 hours. The patients were followed up for 05 days. Results: Bleeding stopped in 464 patients i.e. 80%, while in rest of 20% patients re bleed was observed and managed with review EVS and Octreotide 50g/hour. In 10% (58 patients) bleeding could not be controlled in spite of all efforts. Conclusion: Hepatitis C is the most common cause of Ch. Liver Disease. Acute variceal hemorrhage is the commonest type of upper GIT bleeding and combined Octreotide infusion and EVS treatment is effective in controlling 90% of acute variceal hemorrhage.