Pleuropulmonary complications of esophageal variceal sclerotherapy with absolute alcohol.
BACKGROUND
Esophageal variceal sclerotherapy (EVS) is an effective means of controlling variceal hemorrhage. However, it causes a wide variety of local and systemic complications. The present study was performed to document pleuropulmonary complications of EVS with absolute alcohol.


METHODS
Twenty-six patients of portal hypertension of different etiologies were subjected to EVS with absolute alcohol. Baseline arterial blood gas analysis (PaO2, PaCO2, pH, HCO3, SaO2), chest X-ray and pulmonary function tests (forced expiratory volume at 1 s (FEV1), forced expiratory vital capacity (FVC), FEV1/FVC, maximum mid-expiratory flow rate (MMFR), and peak expiratory flow rate (PEFR)) were performed 4-6 h before the first session of EVS. These investigations were repeated within 24 h of EVS. Patients were asked to maintain a symptom diary and to record symptoms such as fever, chest pain, dysphagia and dyspnea during the study period.


RESULTS
Ten patients (38.46%) had chest pain and four patients (15.68%) had fever after sclerotherapy. Eight patients (30.54%) complained of dyspnea and six patients (23.08%) developed pleural effusion. There was a significant decline in FVC and FEV1 after EVS as compared with baseline values. However, FEV1/FVC ratio, MMFR and PEFR did not have any significant change.


CONCLUSIONS
Chest pain (38.46%), dyspnea (30.54%) and fever (15.68%) were the common symptoms after EVS while chest X-ray showed pleural effusion in 23.08%. Pulmonary function tests revealed a significant decline in FEV1 and FVC without change in FEV1/FVC ratio after EVS, suggesting a restrictive type of defect.
Sethy
Pradeepta K
PK
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Kochhar
Rakesh
R
Behera
Digambar
D
Bhasin
Deepak K
DK
Raja
Kaiser
K
Singh
Kartar
K
D000293:Adolescent; D000328:Adult; D001784:Blood Gas Analysis; D002637:Chest Pain / Q000209:etiology; D016009:Chi-Square Distribution; D004417:Dyspnea / Q000209:etiology; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000209:etiology; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology; D012129:Respiratory Function Tests; D015911:Sclerotherapy / Q000009:adverse effects*; D014797:Vital Capacity
D000431:Ethanol