Endoscopy 1988; 20(4): 134-136
DOI: 10.1055/s-2007-1018157
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Sclerotherapy of Bleeding Esophageal Varices

A Comparative Study of Results in Patients with Schistosomiasis and CirrhosisP. Sakai, S. Boaventura, M. L. Capacci, T. M. Macedo, S. Z. Ishioka
  • Department of Digestive Endoscopy, Hospital das Clinicas, University of São Paulo Medical School, Brazil
Further Information

Publication History

Publication Date:
17 March 2008 (online)

Summary

Endoscopic sclerotherapy for bleeding esophageal varices was carried out in 78 patients with schistosomiasis (Group I) and 71 cirrhotic patients (Group II). All Group I patients had uniformly good liver function. According to Child's classification 25 patients (35 %) of Group II were Child A, 16 (23 %) Child B and 30 (42 %) Child C. The sclerotherapy was performed by intravascular injections of 3 % ethanolamine.

Throughout a follow-up period of at least 24 months, hemorrhage recurred in 13 % of the Group I patients, with one death (1 %). The Child A category had a 24 % recurrence with a 4 % death rate, Child B a 38 % recurrence with a 50 % death rate, and Child C group a 73 % recurrence with no survivals. A comparison of patients with schistosomiasis and cirrhosis type A revealed no differences with respect to rebleeding or survival (p > 0.05). Differences were significant for bleeding recurrence and survival in Child B patients as compared with schistosomiasis patients (p < 0.025). This difference was highly remarkable when patients with schistosomiasis were compared with Child C cases, both for recurrence and survival (p < 0.001). On the basis of these observations it is concluded that results of sclerotherapy depend fundamentally on liver function, and thus this procedure is justified in the early phases of liver cirrhosis.