Endoscopic sclerotherapy for bleeding esophageal varices: effects and complications

Endoscopic esophageal vein sclerosis recently has been revived as a treatment for bleeding varices because long-term results with portacaval shunts have been poorer than suggested by initial short-term studies. Esophageal vein thrombosis secondary to endothelial damage has been considered the result of the activity of the sclerosing agents, but until 1981 there had been little pathologic documentation. Autopsy findings in ten patients who died after variceal sclerosis suggest that variceal obliteration is achieved by mural necrosis followed by fibrosis, and that thrombosis is only a transient phenomenon. Complications of sclerotherapy that were found included ulceration, hemorrhage, perforation, and stricture.