Endoscopic injection sclerosis (EIS) of esophageal varices

A technique for injection of sclerosing agents into esophageal varices using a fiberoptic endoscope in conscious but sedated patients was evaluated. With a flexible needle of our own design, 82 such procedures were performed in 22 patients over a period of 17 months. A solution of 0.5% sodium tetradecyl sulfate, 50% glucose, and 3.5 units of bovine thrombin per ml was used. None of the patients were surgical candidates and all presented with variceal hemorrhage. The complication rate was 2.4% (two of 82 procedures). Prior to beginning injection sclerosis the 22 patients had sustained an average of 3.8 episodes of hemorrhage and the average transfusion requirement was 25.7 units per patient. After instituting therapy the number of episodes of hemorrhage averaged 1.3 per patient with a mean transfusion requirement of 7.3 units.