Treatment of ruptured esophagogastric fundic varices and bleeding

Ruptured esophagogastric variceal bleeding is the most common and fatal complication of cirrhosis in the decompensated phase. The mortality rate of the first bleeding can be 30%-70%, and the mortality rate of the second bleeding is still up to 50%, which mainly presents clinically as vomiting blood or black stool. Endoscopic ligation of esophageal varices and embolization of fundic varices are preferred for treatment. Fundic variceal embolization is mainly done by injecting a tissue adhesive into the varicose veins of the fundus through an injection needle under gastroscopy, and this tissue adhesive is rapidly cured by blood for 20 seconds to block the blood vessels and stop the bleeding, in addition to eliminating the varicose veins of the fundus. For esophageal varices, the first choice is esophageal variceal ligation, that is, the variceal vein is attracted through the ligature under the gastroscope, and then the skin ring is released and the variceal vein is ligated into a venous ball, which is slowly ischemic, necrotic, falling off and finally scarring to eliminate the varices.