Endoscopic injection sclerotherapy of bleeding oesophageal varices: a retrospective analysis.
To evaluate the outcome of endoscopic injection sclerotherapy, a retrospective analysis of patients with bleeding oesophageal varices who underwent emergency or elective sclerotherapy in Tikur Anbessa Hospital from 1985 to 1995 was undertaken. During the study period a total of 43 patients, 32 males and 11 females with a mean age of 46 years, had endoscopic injection sclerotherapy. Aethoxyscterol, ethanolamine oleate or absolute alcohol was used as sclerosant agent. The reduction in variceal size and eradication of varices in patients who received four or more sessions of sclerotherapy was 11% and 74%, respectively, while in patients who received less than four sessions, it was 33% and 25%, respectively. The overall reduction in variceal size and eradication of varices, however, was 23% and 47%, respectively. Rebleeding occurred in 51% of patients. The rebleeding rate in patients who received four or more sessions of sclerotherapy was 26% as compared to 71% in those who received less than four sessions. The in-hospital mortality was 49% and variceal rebleeding occurred in 57% of them. Eighty three percent of the deaths with variceal rebleeding did not achieve eradication of varices and 76% had Child's C liver disease. In conclusion, endoscopic injection sclerotherapy at short interval is effective for eradication of varices and subsequent reduction of rebleeding. The functional status of the liver and variceal bleeding are important determinants of mortality in patients with liver cirrhosis.
Kassa
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Department of Internal Medicine, Faculty of Medicine, Addis Ababa University.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome