IMPACT OF ESOPHAGEAL VARICEAL INJECTION SCLEROTHERAPY ON THE CARDIOPULMONARY HAEMODYNAMICS

Abstract

Portal hypertension is one of the most senous complications of chronic liver disease. It manifests clinically as ascites, splenomegaly, variceal bleeding and porto-systemic encephalopathy. Several factors have been attributed in the pathogenesis of portal hypertension.

Bleeding esophageal varices remain one of the fatal complications of portal hypertension in patients with chronic liver disease. Although several clinical, endoscopic, haemodynamic and sonographic parameters have been investigated in order to predict future variceal bleeding, yet the precise mechanism of varix rupture is still controversial.

Different modalities have evolved that revolutionized the management of active variceal bleeding and subsequent elective management to prevent the recurrence of bleeding.

Endoscopic injection sclerotherapy has become the treatment of choice for both emergency and elective treatment of variceal bleeding. Although EVS is an effective mean of controlling variceal hemorrhage, many complications have been reported. The most common ones are pleuropulmonary, which may be due to capillary injury resulting from the sclerosant entering the pulmonary circulation and/or opening of portopulmonary collaterals.