Variceal Rebleeding and Recurrence After Endoscopic Injection Sclerotherapy

Krige, J. E. J.; Bornman, Philippus C.; Goldberg, P. A.; Terblanche, J.

doi:10.1001/archsurg.135.11.1315

Cited by 35 publications

(29 citation statements)

References 63 publications

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“…10 Varices were obliterated in 93%, similar to cirrhotic patients with figures of up to 87.6%. 11 Previous studies in cirrhotics have shown rebleeding rates of 30% 12 prior to obliteration of varices, similar to our study. Rebleeding was highest during the first two weeks post sclerotherapy with all the mortality in the study occurring during this period.…”

Section: Discussionsupporting

confidence: 92%

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Endoscopic variceal sclerotherapy in patients with Symmers periportal fibroses

Mudawi

Ibrahim²

2007

Trop Doct

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This is a prospective study, carried out in patients with portal hypertension and bleeding oesophageal varices secondary to Symmers (Schistosomal) periportal fibroses, to determine the efficacy of sclerotherapy, the number of sessions needed to achieve full sclerosis, the complications associated with sclerotherapy and the incidence and risk factors for rebleeding. In total, 85 patients were studied with a mean age of 38 years, 76.5% were males. All underwent upper gastrointestinal endoscopy, had different grades of oesophageal varices and underwent intravariceal injection with 5% ethanolamine oleate until they achieved full sclerosis or were referred to surgery. Complications of sclerotherapy included oesophageal strictures, deep oesophageal ulcers, pleural effusion and ascites. Following obliteration of oesophageal varices, 3.5% and 20% developed new gastric varices and portal gastropathy, respectively. Rebleeding occurred in 32% - the only significant predictive risk factor for which was patients with GIII varices following the first sclerotherapy session. Varices recurred in 6% of patients after a mean follow-up period of one year. In total, 93% of our patients achieved full sclerosis after an average of four sessions, and 3.5% were referred for surgery. Three patients (3.5%) died, all from massive rebleeding. In conclusion, sclerotherapy is a safe effective method for treating patients with oesophageal varices due to periportal fibroses.

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Section: Discussionsupporting

confidence: 92%

“…11 In conclusion, sclerotherapy is a safe, effective procedure and a good alternative to surgery for treating patients with bleeding oesophageal varices due to PPF. It is, however, recommended that patients with GIII varices should be closely monitored during the first two weeks following the procedure.…”

Section: Discussionmentioning

confidence: 90%

Endoscopic variceal sclerotherapy in patients with Symmers periportal fibroses

Mudawi

Ibrahim²

2007

Trop Doct

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“…Itha and Yachha 14 reported 40% recurrence rate of esophageal varices in children with EHPVO after variceal eradication using EST. Krije et al 15 reported a 55% recurrence of esophageal varices after variceal eradication in a group consisting predominantly of patients with liver cirrhosis during a mean follow-up of 38 months. Zargar et al 4 reported 13% recurrence of esophageal varices after eradication on 15-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

Natural history of bleeding after esophageal variceal eradication in patients with extrahepatic portal venous obstruction; a 20-year follow-up

Varghese

Jose

Kumar

2009

Indian J Gastroenterol

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“…8 Patients who were mainly affected are the young age group (mean age 42.2 years), and males (72.4%), which is consistent with national and international studies. 8,9,17 The high incidence of hepatitis B infection in sub-Saharan Africa and the possible consequence liver cirrhosis in another important cause of bleeding oesaphageal varices in Sudan. 15 In this study 5 (0.5%) patients were children who had portal vein thrombosis as a cause, they needed fewer (2-3) EST sessions.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Sclerotherapy for Bleeding Oesophageal Varices: Experience in Gezira State, Sudan

Mohammed

2011

Clinical Medicine. Gastroenterology

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Introduction: Bleeding due to oesophageal varices is the most common cause of upper gastrointestinal tract haemorrhage in Gezira State, Central Sudan. Endoscopic injection sclerotherapy (EST) is a valuable therapeutic modality for the management of variceal bleeding. Other options for treatment such as variceal band ligation are either expensive or unavailable. Objectives: A retrospective study to evaluate the outcome of (EST) in the management of bleeding oesophageal varices due to portal hypertension in Gezira State, the centre of a developing country, Sudan. Methods: A total of 1073 patients, during 2001-2010, were carefully selected particularly those with bleeding oesophageal varices consequent to portal hypertension. EST was performed using a standard technique and ethanolamine oleate (5%) was utilized as sclerosing agent. Results: There were 777 males (72.4%) and 296 females (27.6%) in a ratio of 2.6. The causes of portal hypertension were found to be schistosomal periportal fibrosis (PPF) in 1001 (93.3%) patients, liver cirrhosis in 60 (5.5%) mixed PPF and cirrhosis in seven (0.7%) and portal vein thrombosis in five (0.5%) patients. Full obliteration of varices required a mean of four sessions with a range of 2-6. In the present study 350 (32.6%) patients have been followed up until complete sclerosis of varices. Conclusion: This study provides evidence that endoscopic injection sclerotherapy is an important component in the management of bleeding oesophageal varices caused by hypertension. It is a safe and effective procedure.

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Variceal Rebleeding and Recurrence After Endoscopic Injection Sclerotherapy

Cited by 35 publications

References 63 publications

Endoscopic variceal sclerotherapy in patients with Symmers periportal fibroses

Endoscopic variceal sclerotherapy in patients with Symmers periportal fibroses

Natural history of bleeding after esophageal variceal eradication in patients with extrahepatic portal venous obstruction; a 20-year follow-up

Endoscopic Sclerotherapy for Bleeding Oesophageal Varices: Experience in Gezira State, Sudan

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