الفهرس 
ACKNOWLEDGEMENTOnly 14 pages are availabe for public view
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Abstract
Bleeding from esophageal varices still forms a big socioeconomic trouble in our locality. It is said to be a major cause of death in patients with portal hypertension and cirrhosis in our country (Khalil and Fadali, 1962). The management of esophageal varices continues to generate discussion and controversy. A host of treatment options are now available, non of which has proven ideal. Endoscopic injection sclero¬therapy (EIS)• is still widely accepted as the treatment of choice for bleeding esophageal varices, and serves as the standard treatment against which new therapies must be evaluated (Terblanche, 1979). Over the past few years, endoscopic variceal ligation (EVL) has gained popularity on an international scale. Increasing experience has associated in establishing its advantages, but has also highlighted drawbacks (Steigmann et aI., 1990). Preliminary experience with trans- Ijugular intrahepatic porto-systemic shunt (TIPS) has been favorable, and further trials are in progress (Binmoeller, 1994). Pharmacologic therapy has been overshadowed by endoscopic therapy and TIPS, but newer drugs with fewer side effects, such as the long- acting somatostatin analogue; octreotide have attracted interest in this approach. Finally, surgery has spanned new frontiers with the increasing safety of liver transplantation, and remains the only hope for the definitive cure of underlying disease (Wood et aI., 1990