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Variceal bleed – endoscopy — RACP Paediatrics MCQ

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ModerateGIVariceal bleed – endoscopyRACP Paediatrics

The same patient has been resuscitated and stabilised. Octreotide is running. What is the most appropriate definitive treatment for the variceal bleeding?

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Correct answer: E — Upper GI endoscopy

Urgent upper GI endoscopy with variceal band ligation (or sclerotherapy in smaller children) is the definitive treatment for acute oesophageal variceal haemorrhage. It should be performed within 12-24 hours of admission after initial stabilisation. A Sengstaken-Blakemore tube is reserved as a temporising measure for uncontrolled haemorrhage.

Reference: RCH Melbourne – 2023 – GI Bleeding CPG; RACP Paediatric Curriculum – GI