The esophagus after injection sclerotherapy of varices: immediate postoperative changes

Following the endoscopic injection sclerosis (EIS) of esophageal varices, radiographic procedures heretofore have played a minimal role in the dynamic assessment of structural and physiological alterations of the esophagus. This study includes a control esophagogram of each patient before any treatment. Esophageal studies were performed both before and after barium ingestion within a few hours of the treatment session, and findings were contrasted with those of the control esophagography and correlated with those of endoscopy. In all patients, immediately after EIS there was marked narrowing along the distal esophagus with both an upwardly convex border or shoulder effect at the sites of injection and variceal thrombosis. Functional changes of weakened peristalsis or achalasia evolved after early treatment sessions. Delayed emptying of the contrast-medium bolus was observed above the stricture and occasionally in the more proximal esophagus. The radiographic findings demonstrate the immediate sequela of transient dysphagia and the more long term complications of fibrosis and stricture.