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Esophageal variceal sclerosis

J J Reilly, R R Schade, M S Roh

    Surgery, Gynecology & Obstetrics
    |October 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Esophageal varix sclerosis using a flexible endoscope effectively controls bleeding in patients with portal hypertension. This injection therapy is now the primary treatment, reserved for cases unresponsive to sclerotherapy.

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    Area of Science:

    • Gastroenterology
    • Endoscopic interventions
    • Hepatology

    Background:

    • Portal hypertension commonly leads to bleeding esophageal varices.
    • Esophageal varices pose a significant risk of life-threatening hemorrhage.
    • Surgical shunting is not suitable for all patients with bleeding varices.

    Purpose of the Study:

    • To evaluate the efficacy of endoscopic esophageal varix sclerosis in managing bleeding varices.
    • To compare flexible fiberoptic endoscopy with rigid instruments for varix sclerosis.
    • To establish injection sclerosis as a primary therapeutic modality.

    Main Methods:

    • Esophageal varix sclerosis was performed on 20 patients with portal hypertension and bleeding varices.
    • A flexible fiberoptic endoscope was utilized for sclerosis of gastric and esophageal varices.

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  • Repeated injections were administered to control hemorrhage, with a chronic injection protocol for survivors.

    • Main Results:

    • Acute bleeding episodes were controlled in 5 out of 9 cases.
    • Fifteen patients completed initial hospitalization and entered a chronic injection protocol.
    • Recurrent variceal bleeding was controlled in 13 of these patients via sclerosis.

    Conclusions:

    • Injection sclerosis with a flexible endoscope is an effective treatment for bleeding esophageal varices.
    • This endoscopic approach is safer and preferred over rigid instruments.
    • Sclerotherapy is now the primary therapy, with portosystemic shunting reserved for failures.