DISSECTING INTRAMURAL HEMATOMA AFTER ENDOSCOPIC SCLEROTHERAPY OF ESOPHAGEAL-VARICES WITH COMPLETE ESOPHAGEAL OBSTRUCTION

The dissecting intramural hematoma of the esophagus (DEH) is a rare co mplication of endoscopic variceal sclerotherapy (EVS). We present a 37 years male with Laennec's cirrhosis who developed a submucosal hemato ma with complete obstruction of the esophagus 24 h. after the second s ession of EVS diagnosed by endoscopy. After conservative treatment the patient recovered well with complete resolution of the lesion. The re view of the literature shows no correlation between DEH and tipe or vo lume of sclerosant, site of injection or previous number of sessions. Unknown in childrens. Most of these patients had abnormal hemostasis. We have performed EVS in 227 patients (879 sessions), with only a case of DEH (rate 0.13%). In this case the bad tolerance and movements dur ing of EVS were very important.