ENDOSCOPIC INJECTION SCLEROTHERAPY OF BLEEDING ESOPHAGEAL-VARICES - ARETROSPECTIVE ANALYSIS

To evaluate the outcome of endoscopic injection sclerotherapy, a retro spective analysis of patients with bleeding oesophageal varcies who un derwent emergency or elective sclerotherapy in Tikur Anbessa Hospital from 1985 to 1995 was undertaken. During the study period a total of 4 3 patients, 32 males and 11 females with a mean age of 46 years, had e ndoscopic injection sclerotherapy. Aethoxysclerol, ethanolamine oleate or absolute alcohol was used as sclerosant agent. The reduction in va riceal size and eradication of varices in patients who received four o r more sessions of sclerotherapy war 11% and 74%, respectively, while in patients who received less than four sessions, it was, 33% and 25%, respectively. The overall reduction in variceal size and eradication of varices, however, was 23%, and 47%, respectively. Rebleeding occurr ed in 51% of patients. The rebleeding rate in patients who received fo ur or more sessions of sclerotherapy was 26% as compared to 71% in tho se who received less than four sessions. The in-hospital mortality was 49% and variceal rebleeding occurred in 57% of them. Eighty three per cent of the deaths with variceal rebleeding: did nor achieve eradicati on of varices and 76% had Child's C liver disease. In conclusion, endo scopic injection sclerotherapy at short interval is effective for erad ication of varices and subsequent reduction of rebleeding. The functio nal status of the liver and variceal bleeding are important determinan ts of mortality in patients with liver cirrhosis.