THE ROLE OF INJECTION SCLEROTHERAPY IN BLEEDING OESOPHAGEAL VARICES

Abstract

Bleeding oesophageal vances is a major complication of liver cirrhosis, many factors participr.te in the outcome of the managed bleeding patients. These factors include the state of the liver cell function, the det,rree, type and extent of varices, the level of blood clotting factors m1d the etlectiveness and rapidity of controlling bleeding and restoring the blood volume for acute bleeders.

All workers in this field agreed upon the necessity of a rapid and simple technique with little complications for arresting of variceal hemorrhage, the scope of management is wide and includes drugs, balloon tamponade, injection sclerotherapy and operative intervention. The available methods of treating bleeding oesophageal varices should not be viewed as isolated fonn of therapy, but each can be a single link in the chain of therapy.

Sclerotherapy has been reviewed in recent years, because of increasing dissatisfaction with shunting procedures and is currently used either to buy time for patients so that elective surgery may be carried out subsequently, or f()r those patients with poor liver function in whom no other form of therapy is possible or to stop bleeding during the acute attack.

We can conclude that sclerotherapy provides a simple and rapid way of arresting hemorrhage from varices. The technique is practical and seems to be encouraging compared to other lines of management of acute variceal haemon•hage. It may be the only possible procedure in post shunt and unfit bleeders as well as those who refuse surgery.