Introduction. Hemorrhage from esophageal varices is an emergency requiring emergency therapy, the goals of which are to achieve hemostasis, prevent bleeding recurrence and the associated 6-week mortality.

Aim. Analysis of the results of escalation tactics for the use of hemostasis methods for persistently recurring bleeding from esophageal varices in a patient with cirrhosis.

Materials and methods. Sequential escalation of endoscopic hemostasis, insertion of an obturator probe, transjugular portosystemic shunting, laparoscopic esophagogastric devascularization with esophageal transection were performed in a 32-year-old patient with liver cirrhosis of mixed etiology (viral hepatitis C plus alcohol), Child-Pugh class B for persistent recurrent bleeding from esophageal varices in Grodno Regional Clinical Hospital in December 2016.

Results and conclusions. The use of the escalation algorithm in the treatment of repeatedly recurrent bleeding from esophageal varices contributed to the achievement of persistent hemostasis and the absence of recurrence of bleeding from esophageal varices in the postoperative period. The step-by-step application of endoscopic hemostasis, an obturator probe, transjugular portosystemic shunting, laparoscopic esophagogastric devascularization with esophageal transection for persistently recurrent bleeding from esophageal varices is an effective backup algorithm in the treatment and prevention of bleeding of this etiology.

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