31) A55-year-old man with hepatic cirrhosis from alcohol abuse | Surgery videos & books

31) A55-year-old man with hepatic cirrhosis from alcohol abuse presents with a massive hematemesis. This is his third admission for upper GI hemorrhage in the past 2 months. He is currently receiving appropriate therapy for liver failure, including a beta-blocker and diuretics. He is lethargic and confused. His pulse is 100 and blood pressure is 85/40. His initial hematocrit is 20. After fluid resuscitation, which of the following is the most appropriate management strategy?

(A) The transplant team should be called immediately.
(B) The bleeding is probably secondary to an uncontrolled duodenal ulcer related to his alcohol use.
(C) Red blood cells should be administered immediately, but fresh frozen plasma should be withheld if possible.
(D) Endoscopic control options include sclerotherapy and banding. (E) Transjugular intrahepatic portal systemic shunt (TIPS) is not an option in the immediate period.