A 56-year-old man presented with upper GI bleeding in the form of hematemesis and melena. The patient gave a history of chronic liver disease due to chronic HCV infection. The patient underwent upper GI endoscopy which revealed esophageal varices and fundal varices. There is an important sign called The White nipple sign ( a new fibrin clot on varix that has bled recently).
Choose the proper management of this case
a-band ligation of the white nipple first( despite the large fundal varix)
b-Injection sclerotherapy of the white nipple(despite the risk of bleeding)
c-clipping of the white nipple( is it applicable)
d-argon plasma coagulation(is there any experience with that)
e- surgery(what type of surgery)
Choose the proper management of this case
a-band ligation of the white nipple first( despite the large fundal varix)
b-Injection sclerotherapy of the white nipple(despite the risk of bleeding)
c-clipping of the white nipple( is it applicable)
d-argon plasma coagulation(is there any experience with that)
e- surgery(what type of surgery)
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