USE OF OCTREOTIDE IN THE ACUTE MANAGEMENT OF BLEEDING ESOPHAGEAL-VARICES

Acute hemorrhage from esophageal varices is a medical emergency; despi te early diagnosis and treatment the associated hospital mortality rem ains high. The clinical research summarized in this paper shows that o ctreotide has a beneficial effect on portal hemodynamics in cirrhotic patients. In randomized controlled trials octreotide has been effectiv e in halting initial hemorrhage and in preventing reoccurrence of blee ding. Somatostatin and octreotide appear to be equivalent in terms of therapeutic efficacy but octreotide is the less expensive option. For suspected variceal bleeding an octreotide infusion should be initiated immediately. To prevent further bleeding the drug should be continued for two to five days after endoscopic variceal ligation.