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Endoscopy 1990; 22(1): 5-7
DOI: 10.1055/s-2007-1012777
© Georg Thieme Verlag KG Stuttgart · New York

Sclerotherapy of Bleeding Esophageal Varices in Schistosomiasis

Comparative Study in Patients with and without Previous Surgery for Portal HypertensionP. Sakai, S. Boaventura, S. Ishioka, S. Mies, H. Sette Jr., H. W. Pinotti
  • Department of Gastrointestinal Endoscopy and Digestive Surgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Publication History

Publication Date:
17 March 2008 (online)

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Summary

Ninety-seven patients with bleeding esophageal varices due to mansonic schistosomiasis were treated with endoscopic sclerotherapy. Seventy-five patients (Group I) had previously undergone surgery for portal hypertension and presented with bleeding recurrence. Twenty-two patients (Group II) had not undergone surgical treatment. The sclerotherapy technique employed was intravascular (IV) injections of ethanolamine in 40 patients and paravascular (PV) in 57 patients. Of a total of 38 (39 %) patients who had bleeding recurrence, 27 (36 %) were from Group I and II (50 %) from Group II (p < 0.005). Over a follow-up period of 48 to 132 months, 367 sessions of sclerotherapy were carried out in the 72 remaining patients from Group I (4.93 ± 2.05). The remaining 16 patients from Group II needed 121 (7.56 ± 2.70) sessions of sclerotherapy (p < 0.001). Thus, sclerotherapy was effective in the control of rebleeding in 73 (97.3 %) patients from Group I and 16 (72.7 %) from Group II (p < 0.05). We conclude that previous surgical treatment for portal hypertension in patients with mansonic schistosomiasis, greatly benefits treatment of rebleeding esophageal varices by endoscopic sclerotherapy. This is probably due to the lower portal pressure after splenectomy.

Key words:

Esophageal varices - Schistosomiasis - Endoscopic sclerotherapy

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