Esophageal varices - Portal hypertension Management
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After this patient has been hemodynamically stabilized, the next most important step is to perform a diagnostic/therapeutic upper endoscopy. If the source of his bleeding is from esophageal varices, then these can be obliterated with sclerosis or, preferably, endoscopic band ligation. The use of a Sengstaken-Blakemore tube should be reserved for patients in whom upper endoscopy was unsuccessful in controlling the hemorrhage. A TIPS should be considered in patients in whom medical and endoscopic therapy have failed. Barium studies have no role in the evaluation of patients with suspected variceal hemorrhage
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