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    Subjects/Medicine/GI Bleeding — Upper and Lower
    GI Bleeding — Upper and Lower
    medium
    stethoscope Medicine

    A 58-year-old man with a 15-year history of alcohol use disorder presents to the emergency department with hematemesis and melena. On examination, he is tachycardic (HR 110/min), hypotensive (BP 88/54 mmHg), and has clinical signs of cirrhosis including jaundice, spider angiomata, and ascites. Upper endoscopy reveals large esophageal varices with active bleeding. After two units of packed RBCs and fresh frozen plasma, his bleeding is controlled endoscopically with band ligation. Which of the following is the most appropriate next step in the management of this patient to prevent variceal rebleeding?

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