Endoscopic sclerotherapy in acute variceal hemorrhage

American Journal of Surgery
C K PalaniO Jonasson

Abstract

Acute variceal hemorrhage in patients with alcoholic cirrhosis and poor liver function is associated with a high mortality. A nonoperative treatment, endoscopic sclerotherapy, was employed in 22 patients with cirrhosis and poor liver function who had 24 episodes of acute variceal hemorrhage over a 20 month period. Portal hypertension was secondary to alcoholic cirrhosis in 21 patients and cystic fibrosis in 1 patient. Of the 24 patient admissions, 21 were of patients in Child's class C and 3 were class B. Endoscopic sclerotherapy was performed under endotracheal general anesthesia using a modified Negus rigid esophagoscope. The sclerosant (5 percent sodium morrhuate) was injected into all visible varices near the gastroesophageal junction using a MacBeth needle. Definitive control of variceal hemorrhage for the entire hospitalization was achieved in 19 of 24 admissions (79 percent). The in-hospital mortality for acute variceal bleeding was 29 percent; 81 percent of the patients were discharged after control of hemorrhage. There were two major and five minor complications related to sclerotherapy. Based on this preliminary experience it is concluded that injection sclerotherapy controls bleeding and reduces mortality associated...Continue Reading

Citations

Jan 1, 1985·Digestive Diseases and Sciences·L B CohenJ D Waye
Oct 1, 1984·World Journal of Surgery·J Terblanche
Mar 1, 1985·The Japanese Journal of Surgery·J Terblanche
Oct 1, 1985·Gastrointestinal Endoscopy·F L CohenS J Taub
Jul 1, 1987·Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation·S K Sarin
Sep 1, 1984·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·E SeidmanC C Roy
Feb 1, 1984·The British Journal of Surgery·S N Joffe
Oct 1, 1984·World Journal of Surgery·J M HendersonW D Warren
Dec 11, 2014·World Journal of Gastroenterology : WJG·Won Seok JangJun Uk Lim
Jan 1, 1990·The Korean Journal of Internal Medicine·J B ChungH J Choi
Sep 1, 1983·Drug Intelligence & Clinical Pharmacy·S A Mendel, S K Ganju

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