Technical aspects of injection sclerotherapy of acute oesophageal variceal haemorrhage as seen by radiography

Abstract

Certain aspects of the technique of injection sclerotherapy are illustrated in a series of 15 patients presenting with acute oesophageal variceal haemorrhage due to bilharzial hepatic fibrosis. The results of this form of treatment are shown. The actual process of variceal injection was done under visual fluoroscopic control, using a mixture of 76 per cent Urografin and 5 per cent ethanolamine oleate. The findings showed that: (a) the sclerosant did not reach the gastric varices which could be a possible source of re-bleeding; (b) intravariceally injected material rapidly escaped from the submucosal varices, where it should stay, to the peri-oesophageal veins; (c) sclerosant remaining on the variceal walls was minimal by the time the Sengestaken tube was inflated.