Venography during endoscopic injection sclerotherapy of esophageal varices

Utilizing an equal mixture of 5% sodium morrhuate and 60% renografin, we studied four patients during a total of nine sessions of injection sclerotherapy of esophageal varices to determine radiographically the fate of injected sclerosant. Despite attempted intravariceal injections, 44% resulted in local and presumably paravariceal accumulation of contrast material within the esophageal wall. During 42% of injections, contrast material was rapidly cleared in a cephalad direction and proximal balloon compression of the esophagus did not prevent cephalad flow of sclerosant. In 14% the injected material was rapidly cleared in a caudal direction toward the gastric veins. This technique may be useful in future evaluations of the efficacy of various methods of injection sclerotherapy of esophageal varices.