[Endoscopic sclerotherapy of bleeding esophagogastric varices and functional liver status].
Endoscopic sclerotherapy of bleeding gastroesophageal varices was carried out in 52 patients within a sclerosis program for acute hemorrhage. According to Child's classification, 18 (34.6%) were A, 12 (23.1%) B and 22 (42.3%) C. The hemorrhagic focus was endoscopically proven in oesophageal varices in 45 (86.5%) and in 7 (13.5%) in gastric varices. The sclerotherapy was performed by both intra and extravascular injections of 3% ethanolamine according to treatment for emergency bleeding. The procedure was repeated on the 7th day or when necessary for recurrent hemorrhage. Hemostasis was achieved in 94.4% Child's class A, 75.0% Child's class B and 54.5% Child's class C, all of them with bleeding oesophageal varices. All patients with severe gastric hemorrhage (2 Child's class A, 2 Child's class B and 3 Child's class C) needed surgical treatment for uncontrolled bleeding. Liver failure and bleeding were the leading causes of death in 15 (68.1%) Child's class C and 2 (16.6%) Child's class B. There was no death in Child's class A. The conclusion was drawn that the results of endoscopic sclerotherapy of bleeding oesophageal varices was effective and clearly related to liver function. The endoscopic sclerotherapy, however, was not able to control severe hemorrhage from gastric varices and this was not related to liver function.
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A
A
Departamento de Cirurgia, Escola Paulista de Medicina (EPM), São Paulo.
Colleoni Neto
R
R
Caetano Júnior
E M
EM
Jorge Júnior
M E
ME
Lopes Filho
G de J
Gde J
Ricca
A B
AB
Haddad
C M
CM
D001938:Brazil / Q000453:epidemiology; D002648:Child; D002985:Clinical Protocols; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000401:mortality / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000628:therapy; D006801:Humans; D017093:Liver Failure / Q000503:physiopathology*; D008297:Male; D012008:Recurrence; D015911:Sclerotherapy
Escleroterapia endoscópica de varizes esofagogástricas sangrantes e estado funcional do fígado.