Sclerotherapy of bleeding oesophageal varices by means of endoscopy

Abstract

From 1.1.1969 up to 1.11.1977, 640 patients with hemorrhage from gastro-oesopheal varices were managed by sclerotherapy of the oesophageal wall. In 90% this method succeeded in stopping hemorrhage or preventing a new bleeding during the next four months. Only 43 patients of the total number were treated because of impending hemorrhage under precise indications. After two or three sessions of sclerotherapy the interval of control can be extended up to one years without new danger of hemorrhage. Overall mortality was 14.5%; main causes of death were liver coma, uncontrollable hemorrhage, mediastinitis and pyothorax.--If liver function improves, a porto-systemic-shunt is performed whenever possible.--416 = 65% of the patients are still alive; 50% longer than one year up to eight years. Thus sclerotherapy seems to be the method of choice in uncurable massive hemorrhage from varicosities from the oesophagus. It is indicated in patients with decompensated liver function, and whenever a shunt procedure is anatomically or clinically impossible or not advisable, too.