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Figure 1. Bleeding Esophageal Varices.
In an endoscopic photograph of the esophagus of a 56-year-old alcoholic man with massive hematemesis, blood can be seen spurting from a ruptured varix (arrow, Panel A). After injection sclerotherapy of the variceal trunk and immediate hemostasis, the source of bleeding was revealed as a white nipple, which represents what was thought to be a fibrin-platelet plug (arrow, Panel B). Endoscopic variceal ligation was performed for recurrent bleeding from the same source three weeks after the initial episode. The white object in Panel C (arrow) is the remnant of a banded varix.
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