[Endoscopic sclerotherapy of hemorrhagic esophageal varices. 86 cases]. 1994

A Votte, and T Davion, and D Capron, and H Tossou, and J P Capron
Service d'Hépato-Gastroentérologie, CHU Nord, Amiens.

OBJECTIVE Haemorrhage due to rupture of oesophageal varices is a major cause of death in patients with cirrhosis. We evaluated retrospectively our results with endoscopic sclerosis in order to evaluate recurrence, compliance and long-term survival. METHODS Endoscopic sclerosis was performed with a flexible endoscope in 86 patients from 1986 to 1989. Ninety-nine percent of the patients had cirrhosis; they were equally distributed in the 3 Child-Pugh classes. Sclerosis was performed once a week for three weeks then once every 3 weeks until eradication. Sessions was performed during an episode of haemorrhage in 17 patients and begun after bleeding had stopped in 69 others. Mean clinical follow-up was 24 +/- 14 months and mean endoscopic follow-up, 19 +/- 15 months. RESULTS The mean number of sessions was 5.3 +/- 3.5 (range 1-17) per patient. Haemostasis was obtained in 4 out of 17 patients treated in emergency situations. Eradication was attained in 50 patients (58%). Recurrent varices were observed in 28 of these 50 and recurrent bleeding in 13, leading to 2 deaths. Global mortality over the period studied was 36%: 24 patients died before eradication, 7 after and 2 due to extra-hepatic causes. More than two-thirds of the deaths occurred during the first 2 months, mainly after recurrent bleeding. Global actuarial survival was 70% at 12 months, 62% at 24 months and 56% at 36 months. There was a significant difference in actuarial survival between Child-Pugh classes A and B patients and Child-Pugh class C patients. CONCLUSIONS Our experience and the data in the literature indicate that sclerosis can be beneficial in patients with haemorrhagic oesophageal varices, but must be carried out within the framework of comprehensive care and follow-up.

UI MeSH Term Description Entries
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008104 Liver Cirrhosis, Alcoholic FIBROSIS of the hepatic parenchyma due to chronic excess ALCOHOL DRINKING. Alcoholic Cirrhosis,Hepatic Cirrhosis, Alcoholic,Alcoholic Hepatic Cirrhosis,Alcoholic Liver Cirrhosis
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
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
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006471 Gastrointestinal Hemorrhage Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM. Hematochezia,Hemorrhage, Gastrointestinal,Gastrointestinal Hemorrhages,Hematochezias

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