Injection sclerotherapy for oesophageal varices in the elderly

Thirty-seven patients admitted consecutively to the Gastroenterology Unit with haemorrhage from oesophageal varices were treated by injection sclerotherapy. The patients were subdivided according to age at presentation (below 65, over 65 years). The mortality and morbidity of the two groups, over the period of follow-up (mean 5.1 months) were compared. The risk of rebleeding was higher in the elderly (0.23 overall) than in the young (0.11 overall) and was reflected in the higher mortality, four of 14 elderly patients and four of 23 younger patients. A further three elderly patients succumbed to intercurrent illness during the same period. In three of the surviving elderly, complete resolution of varices was noted. Complications of sclerotherapy occurred in eight out of 51 injections in the elderly and six out of 97 in the young but were usually well tolerated. This study suggests that injection sclerotherapy is useful in the treatment of bleeding oesophageal varices in the elderly and suggests recommendations for improved survival.