Cheema M A, David Sohail, Shafique M, Nasir Mehmood, Ajmal Asad, Mustfa Ahsan, Isbah Mushtaq.
Control of acute variceal hemorrhage a comparison of Octereotide and Baloon Temponade.
Biomedica Jan ;20(1):22-7.

A multicenter prospective randomised control trial of patients with acute bleeding from oesophageal varices. Patients not fit for immediate sclerotherapy or band ligation because of severe torrential haemorrhage. This study was conducted at three centers of District Sialkot, i.e., Govt. Sardar Begum Hospital, Allama Iqbal Memorial Hospital, Memorial Christian Hospital from March 1999 to April 2002. The objective was to compare the efficacy and practicality of two commonly used techniques Octeriotide vs Balloon Temponade (BT) for the control of acute variceal haemorrhage. A total of 86 patients were studied in two groups, 46 in Balloon Temponade and 40 in Octeriotide infusion group. These patients presented with acute variceal bleeding. The diagnosis was confirmed by upper GI endoscopy. Stoppage of bleeding was achieved in 44 of 46 patients. Efficacy was 95.65% in Balloon group whereas this was achieved only in 37 of 40 patients. Efficacy was only 85% in Octeriotide group and in BT group complete stoppage of bleeding was seen in 40 (86.96%) whereas minor ooze present in 6(13.04%) at the end of 12 hours. In octeriotide group 25(62.50%) patients achieved complete stoppage of bleeding in (30%) and minor ooze was present, in 3 (7.5%). No effect on bleeding after 12 hours infusion at 50 ug/hour. Balloon Temponade is the only certain way to control acute profuse variceal haemorrhage. This technique is especially valuable during the transport of patients. The efficacy of octeriotide is limited only to minor/moderately severe cases of variceal bleeding or in combination with balloon Tamponade when patients are bleeding from gastric• fundal varices or from portal hypertensive gastropathy.

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