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Endoscopic sclerotherapy in Zimbabwe

C F Kiire1, I T Gangaidzo, J Sitima

  • 1Department of Medicine, University of Zimbabwe, Avondale Harare.

The Central African Journal of Medicine
|September 1, 1993
PubMed
Summary

Endoscopic sclerotherapy effectively controls acute upper gastrointestinal bleeding from oesophageal varices and prevents rebleeding. A weekly treatment schedule is recommended for rapid eradication of varices.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Endoscopic procedures

Background:

  • Oesophageal varices are a common complication of portal hypertension, leading to life-threatening upper gastrointestinal haemorrhage.
  • Various causes of portal hypertension include alcoholic liver cirrhosis, Hepatitis B cirrhosis, and bilharzial portal fibrosis.

Purpose of the Study:

  • To evaluate the efficacy of endoscopic sclerotherapy in controlling acute bleeding and preventing rebleeding in patients with oesophageal varices.
  • To assess the effectiveness of a weekly sclerotherapy regimen for variceal eradication.

Main Methods:

  • Fifty consecutive patients with upper gastrointestinal haemorrhage due to oesophageal varices underwent endoscopic sclerotherapy.
  • Treatment involved a weekly sclerotherapy regimen.
  • Variceal size and eradication were assessed post-treatment.

Main Results:

  • Acute bleeding was controlled in 12 out of 13 patients, including those with fresh bleeds and rebleeding episodes.
  • Significant reduction in variceal size (≥2 grades) was achieved in all 30 patients completing at least four sessions.
  • Complete eradication of varices was observed in 90% (27/30) of patients.
  • Three non-fatal complications (retrosternal pain, fever, dysphagia, ulceration) were noted.

Conclusions:

  • Endoscopic sclerotherapy is a safe and effective treatment for acute oesophageal variceal bleeding.
  • A weekly sclerotherapy schedule facilitates early eradication of varices and prevents rebleeding.
  • The procedure demonstrated a high success rate in variceal control and eradication.

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