• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of gutGutCurrent TOCInstructions to authors
Gut. Feb 1990; 31(2): 213–216.
PMCID: PMC1378383

Sclerotherapy in extrahepatic portal venous obstruction.

Abstract

One hundred and twenty two patients who presented with variceal bleeding as a result of extrahepatic portal vein obstruction (EHPO) were entered into the sclerotherapy programme with a mean follow up of 23.69 months (range four to 60 months). Eighteen (14.7%) patients were lost to follow up, three (2.4%) patients underwent surgery, and six (4.9%) patients died. Variceal obliteration was achieved in the remaining 95 patients requiring 5.4 (2.4) sessions of sclerotherapy (range 2-18). Seventeen episodes of upper gastrointestinal bleed occurred in 15 patients during sclerotherapy. Recurrence of oesophageal varices was seen in 15 patients. Ten patients developed bulbous gastric varices after obliteration. Major complications including perforation and strictures were seen more commonly in children. Sclerotherapy was associated with a significant reduction in the bleeding rate (bleeds/month/patient) as compared with the presclerotherapy period (p less than 0.001). Endoscopic sclerotherapy is an effective and safe modality in the prevention of variceal bleeds in patients with extrahepatic portal vein obstruction.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (793K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Pande GK, Reddy VM, Kar P, Sahni P, Berry M, Tandon BN, Nundy S. Operations for portal hypertension due to extrahepatic obstruction: results and 10 year follow up. Br Med J (Clin Res Ed) 1987 Oct 31;295(6606):1115–1117. [PMC free article] [PubMed]
  • Mitra SK, Kumar V, Datta DV, Rao PN, Sandhu K, Singh GK, Sodhi JS, Pathak IC. Extrahepatic portal hypertension: a review of 70 cases. J Pediatr Surg. 1978 Feb;13(1):51–57. [PubMed]
  • Voorhees AB, Jr, Price JB., Jr Extrahepatic portal hypertension. A retrospective analysis of 127 cases and associated clinical implications. Arch Surg. 1974 Mar;108(3):338–341. [PubMed]
  • Fonkalsrud EW, Myers NA, Robinson MJ. Management of extrahepatic portal hypertension in children. Ann Surg. 1974 Oct;180(4):487–493. [PMC free article] [PubMed]
  • Bismuth H, Franco D, Alagille D. Portal diversion for portal hypertension in children. The first ninety patients. Ann Surg. 1980 Jul;192(1):18–24. [PMC free article] [PubMed]
  • MacDougall BR, Westaby D, Theodossi A, Dawson JL, Williams R. Increased long-term survival in variceal haemorrhage using injection sclerotherapy. Results of a controlled trial. Lancet. 1982 Jan 16;1(8264):124–127. [PubMed]
  • Sauerbruch T, Weinzierl M, Köpcke W, Paumgartner G. Long-term sclerotherapy of bleeding esophageal varices in patients with liver cirrhosis. An evaluation of mortality and rebleeding risk factors. Scand J Gastroenterol. 1985 Jan;20(1):51–58. [PubMed]
  • Paquet KJ. Prophylactic endoscopic sclerosing treatment of the esophageal wall in varices -- a prospective controlled randomized trial. Endoscopy. 1982 Jan;14(1):4–5. [PubMed]
  • Stellen GP, Lilly JR. Esophageal endosclerosis in children. Surgery. 1985 Nov;98(5):970–975. [PubMed]
  • Paquet KJ. Ten years experience with paravariceal injection sclerotherapy of esophageal varices in children. J Pediatr Surg. 1985 Apr;20(2):109–112. [PubMed]
  • Vane DW, Boles ET, Jr, Clatworthy HW., Jr Esophageal sclerotherapy: an effective modality in children. J Pediatr Surg. 1985 Dec;20(6):703–707. [PubMed]
  • Spence RA, Johnston GW, Odling-Smee GW, Rodgers HW. Bleeding oesophageal varices with long term follow up. Arch Dis Child. 1984 Apr;59(4):336–340. [PMC free article] [PubMed]
  • Stamatakis JD, Howard ER, Psacharopoulos HT, Mowat AP. Injection sclerotherapy for oesophageal varices in children. Br J Surg. 1982 Feb;69(2):74–75. [PubMed]
  • Lilly JR, Van Stiegmann G, Stellin G. Esophageal endosclerosis in children with portal vein thrombosis. J Pediatr Surg. 1982 Oct;17(5):571–575. [PubMed]
  • Atkinson JB, Woolley MM. Treatment of esophageal varices by sclerotherapy in children. Am J Surg. 1983 Jul;146(1):103–106. [PubMed]
  • Dall'Oglio L, Bagolan P, Ferro F, Ponticelli A, Cadranel S, Rivosecchi M. Endoscopic injection sclerosis of oesophageal varices in children--indications and techniques. Endoscopy. 1984 May;16(3):98–100. [PubMed]
  • Donovan TJ, Ward M, Shepherd RW. Evaluation of endoscopic sclerotherapy of esophageal varices in children. J Pediatr Gastroenterol Nutr. 1986 Sep-Oct;5(5):696–700. [PubMed]
  • Thatcher BS, Sivak MV, Jr, Petrini JL. Endoscopic sclerotherapy for bleeding esophageal varices secondary to extrahepatic portal vein obstruction. Gastrointest Endosc. 1987 Jun;33(3):214–219. [PubMed]
  • Kahn D, Terblanche J, Kitano S, Bornman P. Injection sclerotherapy in adult patients with extrahepatic portal venous obstruction. Br J Surg. 1987 Jul;74(7):600–602. [PubMed]
  • Howard ER, Stringer MD, Mowat AP. Assessment of injection sclerotherapy in the management of 152 children with oesophageal varices. Br J Surg. 1988 May;75(5):404–408. [PubMed]
  • Dilawari JB, Chawla Y, Locham HS, Prakash S. A low cost endoscopic sclerotherapy needle. Trop Gastroenterol. 1985 Apr-Jun;6(2):104–106. [PubMed]
  • Webb LJ, Sherlock S. The aetiology, presentation and natural history of extra-hepatic portal venous obstruction. Q J Med. 1979 Oct;48(192):627–639. [PubMed]
  • Clatworthy HW, Jr, Nahmad M, Hollabaugh RS. Presinusoidal extrahepatic portal hypertension: a review of thirty-five cases variously treated. Prog Pediatr Surg. 1978;11:125–139. [PubMed]
  • Alvarez F, Bernard O, Brunelle F, Hadchouel P, Odièvre M, Alagille D. Portal obstruction in children. I. Clinical investigation and hemorrhage risk. J Pediatr. 1983 Nov;103(5):696–702. [PubMed]
  • O'Donnell TF, Jr, Gembarowicz RM, Callow AD, Pauker SG, Kelly JJ, Deterling RA. The economic impact of acute variceal bleeding: cost-effectiveness implications for medical and surgical therapy. Surgery. 1980 Nov;88(5):693–701. [PubMed]
  • Agha FP. The esophagus after endoscopic injection sclerotherapy: acute and chronic changes. Radiology. 1984 Oct;153(1):37–42. [PubMed]
  • Tihansky DP, Reilly JJ, Schade RR, Van Thiel DH. The esophagus after injection sclerotherapy of varices: immediate postoperative changes. Radiology. 1984 Oct;153(1):43–47. [PubMed]
  • Sauerbruch T, Wirsching R, Leisner B, Weinzierl M, Pfahler M, Paumgartner G. Esophageal function after sclerotherapy of bleeding varices. Scand J Gastroenterol. 1982 Sep;17(6):745–751. [PubMed]
  • Paquet KJ, Oberhammer E. Sclerotherapy of bleeding oesophageal varices by means of endoscopy. Endoscopy. 1978 Feb;10(1):7–12. [PubMed]
  • Barsoum MS, Abdel-Wahab Mooro H, Bolous FI, Ramzy AF, Rizk-Allah MA, Mahmoud FI. The complications of injection sclerotherapy of bleeding oesophageal varices. Br J Surg. 1982 Feb;69(2):79–81. [PubMed]
  • Voorhees AB, Jr, Chaitman E, Schneider S, Nicholson JF, Kornfeld S, Price JB., Jr Portal-systemic encephalopathy in the noncirrhotic patient. Effect of portal-systemic shunting. Arch Surg. 1973 Nov;107(5):659–663. [PubMed]

Articles from Gut are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...