COMPLICATIONS OF ENDOSCOPIC INJECTION SCLEROTHERAPY

Abstract

One hundred and seventy patients were treated with endoscopic injection sclerotherapy from August 1980 to August 1985. The aim of our method was to perform an itravascular injection of 5 per cent ethanolamine oleate. Complications after injection sclerotherapy were considered minimal if they did not represent an immediate threat of life and were cured with symptomatic treatment. Major complications were related to more serious potentially lethal events, requiring blood transfusion and so forth. Minor complications were chest pain (40.2%), hemoglobinuria (36.0%), esophageal ulcer (31.7%), fever (25.9%) and dyspnea (0.5%). Major complications were noted in 6 cases (3.5%) in which 2 cases (1.2%) died due to these complications. As a cause of death, one was massive bleeding from esophageal ulcer and the other was bleeding from esophageal varices in a patient with hepatocellular carcinoma with A-P shunt. Immediately after injection, arterial oxygen pressure decreased (p<0.05), but arterial carbondioxide pressure, serum potassium, sodium, creatinphosphokinase and hemogrobin were not changed. These changes suggest the presence of a transient pulmono-circulatory disorder. On the occassion of injection, LDH and indirect bilirubin in the serum elevated, which were considered due to hemolysis. It is suggested that the injection sclerotherapy is a relatively safe treatment, if injected exactly into the varices and angiography is performed before injection sclerotherapy except for urgent cases.