Comparison of somatostatin and cimetidine in the treatment of acutely bleeding esophageal varices

Little and conflicting data are reported in the literature on the efficacy of somatostatin in the treatment of acute bleeding of esophageal varices in patients with portal hypertension due to hepatic cirrhosis. In this study the effectiveness of somatostatin has been evaluated in two groups of patients, one group with profuse and the other group with moderate bleeding (with and without Sengstaken-Blakemore tube). The overall rate of success in the two groups is similar, but the mean bleeding period has been significantly reduced in the somatostatin group (15 patients) in comparison with the cimetidine group (14 patients), both in cases without Sengstaken-Blakemore intubation and in severe cases in which local tamponade was required. Somatostatin also markedly reduced the period of intubation. This study confirms that somatostatin may be used as a safe, first choice therapy in the medical management of acute variceal hemorrhage