Tahira Murtaza Cheema, Muhammad Sohail, Muhammad Anjum, Muhammad Arif.
Octreotide and Endoscopic Sclerotherapy in acute variceal hemorrhage.
J Rawal Med Coll Jan ;8(2):93-5.

Background: To observe the effect of sclerotherapy alone or in combination with octreotide in controlling variceal haemorrhage and preventing early rebleeding in patients of cirrhosis. Methods: A total of 130 patients with acute variceal bleeding presenting to emergency of Mayo Hospital, Lahore were included from 1998 - 2003. All the patients underwent first session of sclerotherapy with absolute alcohol. Out of these, 60 cases (46.15%) received octreotide and were put in Group I whereas 70 cases (53.85%) underwent sclerotherapy alone and were included in Group II. Results: In Group I, the age ranged from 35 to 66 years with a mean of 39.53 years whereas in Group II the age ranged from 30 to 69 years with a mean of 37.98 years, In Group I, out of 60 cases, 36 (60%) were male and 24 (40%) were female. In Group II, out of 70 cases, 50 (71.43%) were male and 20 cases (28.57%) were female. In Group I, 16 (26.67%) cases whereas in Group II, 24 (34.29%) cases went into hepatic encephalopathy Grade I to III. In Group I, 4.2 ± 1.4 units whereas in Group II, 4.6 ± 2.3 units of blood transfusions were given in 72 hours. Survival on day 5 was 96.67% (58 cases) and 91.43% (64 cases) in Group I and II respectively. Early rebleeding was only in 13.33% (8 cases) in Group I compared with 22.86% (16 cases) in Group II. Four cases amongst Group I (6.67%) died in the hospital compared with 6 cases (8.57%) in Group II. Conclusions: Octreotide lowers risk of early rebleed and hepatic encephalopathy following variceal bleed and can be recommended for the control of variceal haemorrhage in combination with sclerotherapy.

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