Injection sclerotherapy for oesophageal varices: a ten-year experience

Severe hemorrhage from oesophageal varices is one of the most serious complications in patients with liver cirrhosis and portal hypertension, affecting about 30-70% of the former. This paper reports the results of treatment of oesophageal varices by injection sclerotherapy.

89 patients with oesophageal varices were treated with sclerotherapy in Oulu University Hospital in the period 1982-1991. The indication was acute bleeding in 74 cases and prophylaxis in 15.

Three patients died of rebleeding before eradication of the varices and nine afterwards. Rebleeding was more common in the Child B and C groups than in Child A (p < 0.01). Rebleeding did not correlate with the amount of sclerosant used. The most common complication was oesophageal stricture, noted in 15 patients, although only two required dilatation. This correlated with the amount of sclerosant used (P < 0.05). 34% of the patients died during the follow-up, the overall mortality rate being 14% in Child A cases, 35% in Child B cases and 92% in Child C cases. Mortality was 26% among the patients receiving prophylactic sclerotherapy (4/15) and 35% among those with bleeding varices 35% (26/74). Five patients were operated on for rebleeding problems, four as emergencies and one electively. Two emergency patients died.

While the number of patients in our group receiving prophylactic sclerotherapy was small, our results follow the general survival trend for bleeding varices.