Endoscopic treatment of esophagogastric varices.
We report our current management of variceal bleeding with endoscopic sclerotherapy. We emphasize the importance of resuscitation and of recording at time zero and within the first 72 hours clinical and laboratory indicators, as these influence the management of these patients. Primary sclerotherapy using Histoacryl for active bleeding and Ethoxysclerol for recent bleeding should be performed as soon as the patient is stable hemodynamically. As we have identified factors related to the severity of hemorrhage and of liver failure degree which can predict early failure of sclerotherapy, patients presenting with these findings should be, in the future, referred quickly toward alternative therapies among which non-surgical intrahepatic shunt appears a promising modality.
Adler
M
M
Service Médico-chirurgical d'Hépato-Gastroentérologie, Hôpital Erasme, ULB, Bruxelles, Belgique.
Bourgeois
N
N
Delhaye
M
M
Deviere
J
J
Gay
F
F
Gelin
M
M
Le Moine
O
O
Vandermeeren
A
A
Van Gossum
A
A
Lambilliotte
J P
JP
D003487:Cyanoacrylates / Q000627:therapeutic use; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011379:Prognosis; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015911:Sclerotherapy; D014667:Vasopressins / Q000627:therapeutic use
D003487:Cyanoacrylates; D012597:Sclerosing Solutions; D000077423:Polidocanol; D014667:Vasopressins; D011092:Polyethylene Glycols