A 50-year-old man with cirrhosis presents with haematemesis. Endoscopic confirmation of oesophageal variceal bleeding is awaited, and intravenous octreotide is started immediately. Its benefit in this setting results from:
- A Direct thrombotic occlusion of the bleeding varix
- B Inhibition of fibrinolysis stabilising the platelet plug
- C Splanchnic vasoconstriction reducing portal venous inflow and pressure ✓
- D Reduction of gastric acid secretion promoting clot formation
Correct answer: C. Splanchnic vasoconstriction reducing portal venous inflow and pressure
Explanation
Octreotide is a long-acting somatostatin analogue that constricts splanchnic arterioles, lowering portal venous inflow and portal pressure, and it also suppresses glucagon, a major splanchnic vasodilator. This makes it effective as an adjunct to endoscopic therapy in acute variceal haemorrhage. It has no intrinsic procoagulant or antifibrinolytic activity, and although it mildly suppresses acid secretion, that is incidental to its haemostatic role here.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
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