[Comparative histologic studies following esophageal varices sclerosing with different substances]

Sclerosing varices of the lower esophagus by endoscopic injection of phenol-peanut oil or ethoxysclerol into the submucosal tissue induces inflammatory changes of varying degree. The process of inflammation leads to formation of connective tissue surrounding and protecting the varices, or to obliteration of these vessels. Phenol-peanut-oil induces a rather mild inflammatory process which contains many macrophages and runs a slow course, leading to fibrosis and sclerosis without complications worth mentioning. Ethoxysclerol on the other hand can induce suppurating, almost phlegmonous inflammation; complications like mediastinitis and pleural exsudates are definitively more common than after injection of phenol-peanut oil. Life threatening situations and death may occur after previous treatment by balloon compression and subsequent sclerosing procedures. Therefore, treatment of esophageal varices by sclerosing procedures should only be done, if the esophageal wall has not been altered by mechanical therapeutic measures.