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Emergency Transumbilical Embolization of Bleeding Esophageal Varices
Jurg W. Tauber, MD, PhD;
Robert J. Baker, MD;
Dimitrios G. Spigos, MD;
Stephen L. Winter, MD;
Thomas J. Layden, MD;
Lloyd M. Nyhus, MD
Arch Surg. 1982;117(5):624-629.
Abstract
Eight patients had major hemorrhage from esophageal varices; in seven, one or two embolizations of the coronary and short gastric veins resulted in cessation of hemorrhage. This procedure can be used in patients with massive ascites, severe coagulopathy, or profound liver failure, as the access route through the dilated umbilical vein can be reached via a supraumbilical incision done with the patient under local anesthesia. All patients died; two deaths were attributable to complications of the procedure, the other six to the severity of the cirrhosis. Sclerotherapy may be combined with coronary vein embolization, but the risk of esophageal perforation may be greater than with sclerotherapy alone.
(Arch Surg 1982;117:624-629)
Author Affiliations
From the Departments of Surgery (Drs Tauber, Baker, and Nyhus), Medicine (Drs Winter and Layden), and Radiology (Dr Spigos), University of Illinois College of Medicine, Chicago.
Footnotes
Accepted for publication Jan 8, 1982.
Read before the 89th annual meeting of the Western Surgical Association, Albuquerque, Nov 17, 1981.
Reprint requests to Department of Surgery, University of Illinois College of Medicine, 840 S Wood St, Chicago, IL 60612 (Dr Baker).
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