Endoscopic injection sclerotherapy is an effective method for treating esophageal
variceal hemorrhage [1]
[2]. However, owing to the rapid loss of the sclerosing agent, the overall effect of
sclerotherapy is weakened. Therefore, increasing the residence time of the sclerosing
agent remains a focal point of current investigations. The present study reported
a case treated with a novel technology termed balloon-assisted endoscopic sclerotherapy.
A 48-year-old man was admitted to our department following a diagnosis of esophageal
varices. An endoscopy revealed the presence of four varices in the esophagus, with
a maximum diameter of 1.0 cm ([Fig. 1]). Therefore, endoscopic balloon-assisted sclerotherapy was immediately performed.
The balloon was inserted on the front end of the gastroscope and fixed at a distance
of 3 to 5 cm from the tip ([Fig. 2]). The inner diameter of the balloon was 1.1 cm, and the outer diameter before and
after inflation was 1.3 cm and 1.8 cm, respectively. The endoscope was then used to
enter the vicinity of the treated blood vessel, and the balloon was opened up and
inflated with 2 ml of air ([Fig. 3]). Following this procedure, the selected blood vessel was subsequently treated with
sclerotherapy. Briefly, the sclerosing agent (10 ml polycinnamyl alcohol + 0.1 ml
meilan) was injected into the blood vessel and the balloon was used to continuously
compress the blood vessel for 10 minutes ([Video 1]). The tee was closed after the air in the balloon was completely deflated. On follow-up
1 month later, the patient’s varicose veins were significantly atrophied ([Fig. 4]), and endoscopic ultrasonography showed no obvious blood flow signal under the varicose
vein ([Fig. 5]).
Fig. 1 Endoscopy revealed the presence of four varices in the esophagus, with a maximum
diameter of 1.0 cm.
Fig. 2 Components of the device include the balloon, catheter, and tee. The balloon was
inserted from the front end of the gastroscope and fixed at a distance of 3 to 5 cm
from the tip.
Fig. 3 The balloon was filled with 2 ml of air.
Video 1 A case treated with a novel technology termed balloon-assisted endoscopic sclerotherapy.
Fig. 4 On follow-up 1 month later, the patient’s varicose veins were significantly atrophied.
Fig. 5 Endoscopic ultrasonography showed no obvious blood flow signal under the varicose
vein.
In conclusion, balloon-assisted sclerotherapy under endoscopy was discovered to improve
the therapeutic efficacy of the sclerosing agent. Compared with Tatsuyuki Kawano’s
balloon method [3], the present method was also simpler and more practical.
Endoscopy_UCTN_Code_TTT_1AO_2AD
Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques
in gastroenterological endoscopy. All papers include a high
quality video and all contributions are
freely accessible online.
This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos
