Oesophageal stenosis--a complication of sclerotherapy of oesophageal varices.

Abstract

A total of 246 non-selected patients with oesophageal variceal haemorrhage were treated with the intravascular high-pressure injection technique. Approximately 200 ml of the sclerosant were injected in three sessions. Reliable destruction of the varices in the absence of necrosis/ulceration along the variceal "column" must be considered doubtful. Owing to misplaced (paravasal) injection, 11 patients (4.4%) developed an oesophageal stenosis. All these stenoses were curatively treated with the ESKA-Buess multiple-diameter bougie. The stenosis can be negotiated under endoscopic vision, and, in the immediately following bougienage procedure, dilated up to 16 mm. The presence of mucosal bridges in the stenotic oesophagus is essential for curative bougienage. The use of a circular paravascular injection technique in the distal oesophageal mucosa is not to be recommended.