46
year-old man with no documented liver disease, presented with massive upper
gastrointestinal bleeding. Endoscopy revealed spurting from a large varix in the
gastric fundus (left), seen on retroflexed view. Hemostasis was achieved by the
endoscopic application of a rubber band at the site of bleeding (right).
56 year-old man was
hospitalized with upper gastrointestinal tract bleeding, in hemorrhagic shock,
and in a near-comatose state. Initial endoscopy, prior to volume repletion,
demonstrated no active bleeding, and no varices were visible. Bleeding recurred
several days after circulating volume had been restored with transfusions and
volume infusions. At that time, endoscopy demonstrated massive bleeding from
this distended varix in the gastric fundus. Endoscopic rubber-banding
effectively controlled the bleeding.
55 year-old man with alcoholic
cirrhosis who presented with massive hematemesis (vomiting blood). Active
pulsatile bleeding from a gastric fundic varix was seen at endoscopy. Bleeding
was successfully controlled by the endoscopic placement of a band at the
bleeding site.