Abstract
Background and Study Aims: The effect of sclerotherapy of esophageal varices on the development of gastric varices
is a controversial question. The aim of the present study was to evaluate prospectively
the presence and development of gastric varices as a consequence of esophageal variceal
sclerotherapy.
Patients and Methods: We prospectively studied 227 patients, all of whom had liver cirrhosis at the time
of the first bleeding episode due to esophageal varices. All patients were treated
with emergency endoscopic sclerotherapy, and further courses of sclerotherapy to eradicate
the varices were given at seven-day intervals for three sessions, and then every fifteen
days until eradication was complete. At the time of inclusion in the study, patients
were divided in two groups: group A, with initial gastric varices, and group B, without
any gastric varices initially.
Results: Group A included 138 patients (60.8 %), in 99 of whom (71.7 %) disappearance of the
gastric varices was observed. In 63 cases (63.6 %) the varices were eliminated during
the sclerotherapy treatment, before the eradication of esophageal varices; in 36 cases
(36.4 %), the gastric varices disappeared after the eradication of the esophageal
varices. Group B included 89 patients (32.9 %); in 78 of them (87.6 %), no appearance
of gastric varices was observed, while in 11 (12.4 %), gastric varices appeared.
Conclusions: From these data, it can be concluded that sclerotherapy of esophageal varices cannot
be a determinant factor either for the appearance of gastric varices or for their
subsequent risk of bleeding.
