Endoscopic Image of bleeding of Esophageal Varix At the at the time of being exploring the stomach, the patient present a cough reflex, causing rebleeding of the varix. The white nipple sign correlated positively with severity of bleeding (patients required more blood transfusion), hematemesis, and signs of shock. Patients with the white nipple sign also tended to undergo emergency endoscopy and have active bleeding at the time of endoscopy. There was no correlation between rebleeding rate after endoscopic therapy and presence of the white nipple sign.
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