Oesophageal ulceration after sclerotherapy--a complication or an accompaniment?

Forty eight patients with oesophageal varices were serially endoscoped over a period of 3 weeks for the presence of oesophageal ulcers after the first course of sclerotherapy with absolute alcohol. Post-sclerotherapy oesophageal ulcers were seen in 94% patients on day 1, in 69% patients at 1 week and in only 12.5% patients at the end of 3 weeks. A strong correlation (r = + 0.88) was observed between the incidence of ulceration and the amount of sclerosant injected. In fact, all patients who received 3 ml or more of the sclerosant showed development of oesophageal ulcers. It can be concluded that oesophageal ulcers are probably a necessary accompaniment of sclerotherapy and should not be considered an avoidable complication.