21st April 2024

A 39-year-old gentleman with Child-Pugh C alcoholic liver cirrhosis presents with haematemesis and melaena

A 39-year-old gentleman with Child-Pugh C alcoholic liver cirrhosis presents with haematemesis and melaena. He has had 2 previous episodes of upper GI bleeding in the past 18 months and is on maximum dose beta-blockers. He is treated with terlipressin and undergoes endoscopy with band ligation of two oesophageal varices. However, within 24 hours he develops further melaena and a repeat endoscopy shows ongoing bleeding.

What is the most appropriate management option for this patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.