Clinical evaluation of endoscopic injection sclerotherapy for bleeding esophageal varices in liver cirrhosis with hepatocellular carcinoma.
Endoscopic injection sclerotherapy (EIS) for rupture of esophageal varices was carried out in 13 patients of liver cirrhosis with hepatocellular carcinoma (HCC). Sclerotherapy was performed by intravariceal injections of 5% ethanolamine oleate. According to the manual for the staging of cancer, these HCCs were classified as Stage I in 1 case, II in 1 case, III in 2 cases, and IV in 9 cases. There was no difference between post EIS prognosis and stage. Child's classification of these patients were class A in 1 case, B in 5 cases, and C in the remaining 7 cases. Only in 1 case of Child's A and 1 case of Child's B who were less advanced clinically and were free from icterus and ascites did EIS produce favorable results, it arresting esophageal variceal hemorrhage and led to a relatively good outcome. We suggest that emergency EIS for rupture of esophageal varices should be performed in patients with relatively good general conditions, irrespective of the stage of HCC.
Nakashima
M
M
Third Department of Internal Medicine, Kumamoto University Medical School, Japan.
Yoshida
K
K
Izuno
K
K
Murata
H
H
Fujiyama
S
S
Sato
T
T
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D004630:Emergencies; D016145:Endoscopy, Digestive System; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy