A rare complication of endoscopic injection sclerotherapy: Thrombosis of subclavian vein

A 28-year-old man with compensated cirrhosis of the liver (Child B) and aft er 4 episodes of esophageal variceal bleeding received prophylactic endosco pic variceal sclerotherapy in our Gastroenterology Clinic for 8 consecutive months. Sclerotherapy of the esophageal varices had been performed at mont hly intervals until variceal obliteration was achieved. Both the intravaric eal and paravariceal injection techniques were used and injections were rep eated periodically as necessary. On the 8th month, 1 week after the 4th scl erotherapy procedure, the patient complained of swelling on his right shoul der and on his right arm. There was jugular congestion and swelling of his right arm and right shoulder. The patient was hemodynamically stable. An X- ray of brachial venography revealed an obstruction of the vena subclavia de xtra. During follow-up, the jugular congestion and swelling of his right ar m gradually subsided spontaneously over a 6-month period without any need f or medication. There has been no recurrence of his symptoms during the 1-ye ar follow-up period. Now, he is still well clinically. This experience sugg ests that endoscopic injection sclerotherapy may cause thrombosis of the su bclavian vein which have been never seen before.