[What vasoactive agent should be chosen in rupture of esophageal varices in cirrhosis?]

Variceal esophageal bleeding is a frequent and severe complication of portal hypertension. Balloon compression was the standard therapy for many years. Currently, endoscopic hemostasis with sclerosis or ligation appears to be more effective but requires an experienced operator who is not always present at emergency situations. Parenteral administration of vasoactive agents is one therapeutic option offering new perspectives for the future. Data in the literature suggest that terlipressin or somatostatin would be the preferential choice because of the adverse effects of vasopressin. Data is insufficient concerning sandostatin. Currently, the trend is to administer vasoactive agents as soon as possible, prior to hospitalization and, perhaps, in association with endoscopic hemostasis. Treatment should be maintained for several days although the cost/benefit ratio remains a question of debate.