The complications of injection sclerotherapy of bleeding oesophageal varices

Abstract

The complications of injection sclerotherapy were retrospectively studied in 122 patients with acute variceal bleeding. Initial control of bleeding was achieved in 72.5 per cent of patients and the final success rate of sclerotherapy was 86.1 per cent. The overall morbidity rate was 30.3 per cent. Minor complications occurred in 13.9 per cent of patients and major complications were recorded in 16.4 per cent. Twenty patients developed complications directly attributable to sclerotherapy: 14 minor and 6 major. The overall mortality rate was 21.3 per cent, and 7.4 per cent of the patients died due to complications. Pulmonary complications occurred in 15 patients and resulted in 3 deaths. Retrosternal pain developed in 8 patients, but dysphagia and oesophageal ulceration were rare. No stricture was recorded. The incidence of liver failure in 17 Child's grade C cases was almost certainly a complication of the underlying disease rather than the injection therapy. It is suggested that injection sclerotherapy is an effective and relatively safe treatment for variceal bleeding.

Acute respiratory distress syndrome following esophageal varice sclerotherapy

“…In adults, the procedurerelated mortality has been reported to range from 0% to 11.8% [6,7]. Among those mentioned previously, pulmonary complications are commonly noted, occurring in 12%-50% of adult patients [7][8][9][10]. Pleural effusion, the most frequent pulmonary complication, is usually small and can occur equally in both sides [9][10][11].…”

“…In adults, the procedurerelated mortality has been reported to range from 0% to 11.8% [6,7]. Among those mentioned previously, pulmonary complications are commonly noted, occurring in 12%-50% of adult patients [7][8][9][10].…”

“…There has been no case report in the pediatric population, but it has been sporadically seen in adults [6][7][8]12,13]. Sclerosing agents themselves, of course, have been reported to induce ARDS, although blood loss associated with severe hypotension, massive transfusion, aspiration of gastric content, and sepsis could lead to this condition [8,12,[14][15][16].…”

Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

“…It has even been suggested that liver dysfunction is an independent risk factor for bacteremia after EVS or EVL (6,40) , yet this claim is not supported by all (46) . The present study cannot support this issue because of the limited number of cases for comparison, as only one patient showed positive blood culture after EVL, and nevertheless he was of the Child-Pugh A class.…”

Endoluminar Sclerotherapy (ES) of Oesophageal Varices: Technique and Preliminary Results1

“…whe reas intravaricea l techniques by systemic com plications such as para -p\egias , intestina l pseudo-obstruction . ana ph ylactic reac tio ns (3,4,5,6,9,10). A co mbina tion o fbo t h tec hniq ues ca n resu lt in th e summat ion 01' all these risks.…”