Follow-up study after sclerotherapy

In a prospective study, 200 patients with variceal bleeding (179 cirrhosis, 21 noncirrhotic) who were treated by long-term sclerotherapy were followed for periods up to 6 years. Varices were obliterated in 162 (81%) with a median of four courses of injection. 'New' varices developed in 99 cases and were a cause of bleeding in 28, of whom 3 died. The recurrence of varices was almost always observed within 12 months of initial obliteration. A median of two courses of sclerotherapy were required to again achieve obliteration. In 20 patients a second recurrence of varices occurred with bleeding in 8 cases but no associated deaths. Based on these observations we recommend regular follow-up endoscopy after obliteration, particularly in the 1st year, to detect and treat varices before they are a cause of bleeding.