LIGATION OF HEPATIC AND SPLENIC ARTERIES

THE CONTROL and treatment of hemorrhage arising from ruptured esophageal or gastric varices is one of the most difficult problems confronting the internist and surgeon. These varices in human beings usually are associated with portal hypertension. Efforts to control or prevent this type of hemorrhage have usually been directed toward the varicose veins themselves or toward the correction of the underlying problem of portal hypertension.

Esophageal bleeding has been arrested by methods such as insertion of suitable types of tubes with balloons, injection of the veins with sclerosing agents, excision of varices on the outside of the esophagus, excision of the lower third of the esophagus and the cardiac end of the stomach, and even excision of the entire stomach with an anastomosis between the esophagus and the jejunum. Other methods have been used in an attempt to decrease portal hypertension and thus decrease the vulnerability of the veins to