Limitations of multiple injection sclerotherapy sessions for acute variceal bleeding. 1986

P C Bornman, and J Terblanche, and D Kahn, and M A Jonker, and R E Kirsch

Sixty-six patients with active bleeding (127 episodes) from oesophageal varices treated by balloon-tube tamponade followed by injection sclerotherapy with a rigid endoscope were followed up for at least 1 year and analysed to determine whether the number of acute injection sessions during each hospital admission (87) or any other known parameter of liver function, e.g. Child's grading, affected the outcome. Definitive control of bleeding was achieved with one or two injections during 75 of these admissions (86%) with a mortality rate of 21%. However, the mortality rate in those patients who received three or four injections was 66% and reached 89% when Child's category A patients were excluded. It is concluded that the mortality rate in poor risk patients becomes unacceptably high when more than two injection sessions are required during a single hospital admission. Other methods of treatment, such as emergency portacaval shunting or devascularization procedures, should be instituted in the small subgroup of patients whose variceal bleeding is not controlled by two injection sessions.

UI MeSH Term Description Entries
D004932 Esophageal and Gastric Varices Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL). Esophageal Varices,Gastric Varices,Esophageal Varix,Gastric Varix,Varices, Esophageal,Varices, Gastric,Varix, Esophageal,Varix, Gastric
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012306 Risk The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome. Relative Risk,Relative Risks,Risk, Relative,Risks,Risks, Relative
D012597 Sclerosing Solutions Chemical agents injected into blood vessels and lymphatic sinuses to shrink or cause localized THROMBOSIS; FIBROSIS, and obliteration of the vessels. This treatment is applied in a number of conditions such as VARICOSE VEINS; HEMORRHOIDS; GASTRIC VARICES; ESOPHAGEAL VARICES; PEPTIC ULCER HEMORRHAGE. Injections, Sclerosing,Sclerosant,Sclerosing Agent,Sclerosing Agents,Sclerosing Injection,Sclerosing Solution,Sclerosants,Sclerosing Drugs,Sclerosing Injections,Agent, Sclerosing,Agents, Sclerosing,Drugs, Sclerosing,Injection, Sclerosing,Solution, Sclerosing,Solutions, Sclerosing
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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