skip to main content

Variceal upper GI bleeding — SCE Acute Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardAcute GI PresentationsVariceal upper GI bleedingSCE Acute Medicine

A patient with cirrhosis has an acute variceal haemorrhage controlled by endoscopic band ligation. He is Child–Pugh class C10, has no severe cardiopulmonary disease and remains haemodynamically stable after initial treatment. Which intervention should be considered to reduce early rebleeding and mortality?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Arrange pre-emptive transjugular shunting within 72 hours

High-risk patients—particularly Child–Pugh C 10–13 or selected Child–Pugh B patients with active bleeding—should be assessed for pre-emptive TIPS, ideally within 72 hours, after initial endoscopic and vasoactive treatment. Balloon tamponade or an oesophageal stent is a short bridge for uncontrolled bleeding, not secondary prophylaxis.

Reference: https://www.bsg.org.uk/getmedia/a45c14c0-6060-4b58-a729-6a388193a068/flgastro-2026-103698.pdf