Endoscopic Intravariceal Injection Sclerotherapy with 5% Ethanolamine in 187 Acute Oesophageal Variceal Bleeding Patients

Abstract

Abstract:One hundred and eighty seven patients (161 males and 26 females) with endoscopically proven active variceal bleeding underwent endoscopic sclerotherapy by the intravariceal method (EST). All of the patients were cirrhotic and 37.4 percent (70/187) had associated underlying diseases. The patients' status before EST, according to Child‐Turcotte's classification, were class A % 6.4%, class B = 49. 7%, and class C = 43% respectively.An intravariceal injection with 4 ml of ethanolamine oleate per varix through an Olympus fiberoptic scope was performed. Then sclerotherapy sessions required for each patients was different. Seventy four percent (138/187) required only one session. Neither a compression balloon nor sliding tube after injection were used. Bleeding was arrested in all cases after this method.The results revealed that recurrent bleeding developed in 17.6 percent of the patients (33/187) and occurred between one day (one case) to two years afer EST. Hemorrhagic gastritis (22/187) was the major cause of post sclerotherapy bleeding. Complications related with EST in this report occurred in two patients (1.06 percent). The first case had a low grade fever after treatment which spontaneously subsided on day three after EST without any specific medication. The other one had oesophageal perforation and died with severe post operative sepsis.