In patients with cirrhosis and portal hypertension, gastrointestinal haemorrhage is a major complication and cause of death. Oesophageal varices are present in approximately 50% of patients with cirrhosis; the prevalence is higher in Child-Pugh C patients than in those with Child-Pugh A-B. Among patients with varices, the risk of gastrointestinal haemorrhage ranges from 30% to 50% and half of these patients die within six weeks after bleeding. Thus 10–15% of unselected patients with cirrhosis die from gastrointestinal bleeding. The number of deaths has decreased in the last few decades as a result of modern techniques (see below). The exact mechanisms of variceal rupture have not yet been determined and thus no ideal treatment has been found. However, haemorrhage has been shown to cause different complications such as sepsis or renal failure which may be responsible for death. In patients admitted for variceal haemorrhage, certain prognostic factors for death have been determined such as age, Child-Pugh C, hepatocellular carcinoma, early rebleeding, hepatic encephalopathy, and renal failure.1

Ideally, patients admitted for acute variceal haemorrhage must be taken to a medical centre with an emergency facility and an intensive care …