[Pulmonary circulatory disturbance following endoscopic injection sclerotherapy].
We compared arterial blood gas analysis and 99mTc-MAA lung perfusion scintigraphy before and after endoscopic injection sclerotherapy (EIS) in 17 cases of esophageal varices complicating liver cirrhosis. EIS was performed by the intra-variceal injection method with 5% ethanolamine oleate (EO) as the sclerosant agent. In blood gas analysis, the mean values of partial arterial oxygen tension (PaO2) and oxygen saturation (SaO2) were decreased, and the mean value of alveolar-arterial O2 difference (AaDO2) was increased, compared with before EIS while breathing room air. On lung perfusion scintigram, the pulmonary blood flow was markedly decreased, demonstrating hypoperfusion and/or perfusion defect, compared with before EIS in most the cases. It was suggested that pulmonary embolism and/or pulmonary circulatory disturbance occurred after EIS. It is important to note that pulmonary circulatory disturbances potentially may occur after EIS without any accompanying symptoms such as dyspnea, cough, or hemoptysis.
Uchibori
S
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Second Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
D000328:Adult; D000368:Aged; D004932:Esophageal and Gastric Varices / Q000503:physiopathology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009829:Oleic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D011652:Pulmonary Circulation / Q000187:drug effects*; D011655:Pulmonary Embolism / Q000139:chemically induced / Q000503:physiopathology; D011877:Radionuclide Imaging; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D015911:Sclerotherapy / Q000009:adverse effects*; D013668:Technetium Tc 99m Aggregated Albumin
D009829:Oleic Acids; D012597:Sclerosing Solutions; D013668:Technetium Tc 99m Aggregated Albumin; C033343:ethanolamine oleate