Multiple Infusions of Posterior Pituitary Extract in the Treatment of Bleeding Esophageal Varices

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Abstract
Although posterior pituitary extract has been shown to stop bleeding from esophageal varices, its effect has been transient, and it has apparently not decreased the mortality rate significantly. We have evaluated the effect of Pituitrin in consecutive patients with histologically-proven cirrhosis in whom the diagnosis of bleeding esophageal varices was established by esophagoscopy. Bleeding was controlled for at least 24 hours in 40% of 25 bleeding episodes in 16 patients, and for shorter periods in an additional group. All of the first 8 patients who received single infusions of posterior pituitary extract died, even though the hemorrhage was sometimes controlled transiently. Six of the next 8 patients who were treated with multiple infusions of posterior pituitary extract administered more rapidly, more frequently and more regularly survived bleeding. Based on these observations a tentative regimen for the treatment of actively bleeding esophageal varices is proposed.