Related Experiment Videos
Sclerotherapy for esophageal varices
1Division of Gastroenterology, Georgetown University Hospital, Washington, DC 20007.
DICP : the Annals of Pharmacotherapy
|November 1, 1990
Summary
Endoscopic injection sclerotherapy (EIS) effectively treats acute esophageal varices bleeding. However, recent data suggest EIS may not be valuable for prophylaxis, and it carries a risk of complications.
Area of Science:
- Gastroenterology
- Endoscopy
- Hepatology
Background:
- Esophageal varices pose a significant bleeding risk.
- Endoscopic injection sclerotherapy (EIS) is a common treatment for esophageal varices.
- Interest in EIS has grown due to limitations of other treatment modalities.
Purpose of the Study:
- To evaluate the efficacy of EIS in managing esophageal varices.
- To assess the role of EIS in both acute hemorrhage control and prophylaxis.
- To review complications associated with EIS.
Main Methods:
- Review of clinical trials and recent data on EIS for esophageal varices.
- Comparison of different sclerosing agents, focusing on ethanolamine oleate.
- Analysis of intravariceal versus paravariceal injection techniques.
Main Results:
- EIS demonstrated efficacy in controlling acute esophageal variceal hemorrhage, though some studies show conflicting results.
- Recent evidence does not support the use of EIS for prophylaxis.
- Ethanolamine oleate is a preferred sclerosing agent for EIS.
- The intravariceal method is more effective and faster than the paravariceal method.
- Significant complications from EIS occur in up to 15% of patients, including pain, fever, and sepsis.
Conclusions:
- EIS remains an important tool for managing acute esophageal variceal bleeding.
- The prophylactic value of EIS is questionable based on current data.
- Careful consideration of risks and benefits is necessary when using EIS.