[Esophagogastric varix hemorrhage. Experience with cyanpoacrylate and polidocanol in 68 patients with active hemorrhage].
BACKGROUND
Sclerosis, injection of cianoacrylate and rubber band ligation are the most commonly used endoscopic techniques for the treatment of bleeding esophageal varices.


OBJECTIVE
To assess the effectiveness of cianoacrylate and polidocanol in the treatment of bleeding esophageal varices.


METHODS
Sixty eight patients with active variceal bleeding were studied. Bleeding varices were classified as thin, thick or gastric. Bleeding from thin varices was treated with polidocanol. Bleeding from thick or gastric varices was treated with cianoacrylate. Variceal eradication was done with polidocanol.


RESULTS
Bleeding came from thin esophageal varices in 23% of patients and endoscopic treatment stopped bleeding in 95% of them, from thick esophageal varices in 62% and endoscopic treatment was successful in 94% of these, and from gastric varices in 12% and treatment stopped bleeding in 87% of these (in 3% bleeding was considered subcardial). Twenty-five percent of patients bled again during variceal eradication, 12% died due to uncontrollable bleeding and 20% died due to liver failure. During variceal eradication 59% of patients classified as Child Pugh C, died.


CONCLUSIONS
Treatment of bleeding esophageal varices with cianoacrylate or polidocanol is effective. Patients classified as Child Pugh C have a had prognosis.
Vargas
L
L
Departamento de Gastroenterología, Hospital San Juan de Dios, Area Occidente de la Universidad de Chile, Santiago de Chile.
Ovalle
L
L
Estay
R
R
Sepúlveda
P
P
Mella
B
B
Soto
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004932:Esophageal and Gastric Varices / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use*
D003487:Cyanoacrylates; D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols