Document Detail


Comparative efficacy of emergency endoscopic sclerotherapy for active variceal bleeding due to cirrhosis of the liver, non-cirrhotic portal fibrosis and extrahepatic portal venous obstruction.
MedLine Citation:
PMID:  2129815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with continued variceal bleeding due to portal hypertension (n = 202) were treated by endoscopic injection sclerotherapy after resuscitation. Portal hypertension was due to hepatic cirrhosis in 123, non-cirrhotic portal fibrosis (NCPF) in 49 and extrahepatic portal venous obstruction (EHO) in 30 patients. Polidocanol 1% was injected intravariceally. An adequate sclerotherapy was carried out in 97% of patients. Immediate haemostasis was achieved in 177 (88%) patients. Rebleeding occurred in 31 (17.5%) of 177 patients. By reinjection of varices, definitive control of bleeding occurred in 160 (79%) patients. There was no significant difference in terms of immediate control of bleeding in patients with different aetiologies of portal hypertension and hepatic functional status (Child's grade). Rebleeding episodes were lower in patients with EHO than cirrhosis of the liver and NCPF. Similarly, the Child's status significantly influenced the recurrence of bleeding which was lower in Child's A than B and B than C. The in-hospital mortality was 18.6%. This was also significantly related to Child's status and aetiology of portal hypertension. Minor complications occurred in 10.4% of patients. It is concluded that endoscopic sclerotherapy as the first line of treatment is an effective and technically feasible procedure for the control of active variceal bleeding, regardless of the cause of portal hypertension. Furthermore, the results were influenced by the aetiology of portal hypertension and hepatic functional status.
Authors:
D K Bhargava; S Dasarathy; S P Atmakuri; M Dwivedi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  5     ISSN:  0815-9319     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:    1990 Jul-Aug
Date Detail:
Created Date:  1991-11-01     Completed Date:  1991-11-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  432-7     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi.
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MeSH Terms
Descriptor/Qualifier:
Adult
Emergencies
Esophageal and Gastric Varices / etiology,  therapy*
Female
Gastrointestinal Hemorrhage / etiology,  therapy*
Humans
Hypertension, Portal / complications*
Liver Cirrhosis / complications*
Male
Polyethylene Glycols / therapeutic use
Recurrence
Sclerosing Solutions / therapeutic use
Sclerotherapy*
Chemical
Reg. No./Substance:
0/Polyethylene Glycols; 0/Sclerosing Solutions; 9002-92-0/polidocanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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