[Endoscopic sclerotherapy of esophageal varices. Personal cases]

The authors present their experience of endoscopic sclerosis of esophageal varices in 56 patients in a period of about two and half year (February '83-July '85). 46% of the patients were of the group C according to Child's criteria and 48.2% showed a fourth degree varices according to Paquet's criteria. Twenty-nine patients (51.7%) were submitted to the sclerosis as emergency treatment, 17 patients (30.3%) had an elective procedure and 10 (17.8%) were treated by a prophylactic sclerosis. The hemorrhage was stopped in 25 cases (86%) among emergency treated patients. However a new hemorrhage was observed before the end of the cycle of treatment in 48%. On the contrary 17% of patients complained recurrent hemorrhage after completing the treatment. Thirty-five per cent of patients electively treated showed recurrent hemorrhage while 40% bled after prophylactic treatment. Thirty-eight patients had a follow up of one year with results very similar to these reported in the literature. As a conclusion, on the bases of the reported results the authors suggest to submit to this treatment all the patients with recent hemorrhage or in emergency. The sclerosis should be reserved as elective procedure only to the patients of the class C; class A should be reserved to surgery while patients of the class B are matter of debate. Moreover prophylactic treatment, theoretically very attractive, needs further evaluation, at least in their hand.