The authors conclude that (i) sclerotherapy is the ideal, safe and effective treatment for bleeding esophageal varices, that it prevented bleeding in 88.1% patients after variceal eradication and hence, should be included in primary management strategies; (ii) follow-up endoscopy should be performed on a yearly basis for the first 4 years after variceal eradication; and (iii) surgery is required as a complementary technique for patients with uncontrolled bleeding, painful splenomegaly, growth retardation and symptomatic portal biliopathy.

In patients with bleeding peptic ulcers, the use of high dose pantoprazole infusion following successful endoscopic therapy is effective in reducing rebleeding, transfusion requirements and hospital stay.

No abstract

A 15-year-old boy presented with long-standing bleeding of the rectum to the department of gastroenterology. Per rectal digital examination and proctoscopy did not reveal any definite local cause of bleeding. The patient was sent to the department of radiology for computed tomography (CT) scan. CT was done on 64 multislice CT scan, which shows marked rectosigmoid wall thickening as a result of varices and vascular malformations and phleboliths of the rectosigmoid colon. The patient was subjected to abdominal surgery in which a sphincter-saving procedure was done. Postoperative course in the hospital was uneventful.

Obturator hernia is rare, constituting <2% of all abdominal hernias. Clinical diagnosis is rarely made due to vague signs and symptoms. Delayed diagnosis markedly increases postoperative morbidity and mortality especially because the affected patients are often old with other comorbid conditions. Pelvic CT is almost 100% accurate in the diagnosis of obturator hernia and should be the modality of choice in older patients presenting with intestinal obstruction of unknown etiology.