Injection Sclerotherapy for Esophageal Varices after Total Gastrectomy: Case Reports of Two Patients

Abstract

Abstract:Injection sclerotherapy was performed in two patients with esophageal varices who had undergone a total gastrectomy and Roux‐en‐ Y esophagojejunostomy for gastric cancer. Both of the patients were diagnosed as having postnecrotic liver cirrhosis due to serum hepatitis. The first patient developed esophageal varices after surgery. The second patient had recurrent esophageal varices after surgery for both gastric cancer and the esophageal varices. Five percent ethanolamine oleate was the sclerosant used together with the contrast medium iopamidol (5% EOI). After intravariceal injection, the flow of the sclerosant was followed by fluoroscopy. The esophageal varices were fed by the branches of the jejunal vein of the arcade of the ascending jejunal limb. The esophageal varices and branches of the jejunal vein were destroyed by three consecutive sessions of sclerotherapy. No complications occurred during or after the therapy. Therefore, injection sclerotherapy, along with varicealography, is one of the most effective methods of treating esophageal varices arising after a total gastrectomy.