Abstract
The effects of endoscopic injection sclerotherapy (EIS) were evaluated in 26 patients with esophageal varices by using color Doppler endoscopic ultrasonography (CDEUS). Of these, 21 patients underwent CDEUS before and after EIS. The color Doppler flow mapping before EIS revealed that esophageal varices were mainly located in the sub-mucosa and the blood flow was characteristically turbulent and hepatofugal. CDEUS just after EIS showed that the varices changed to echogenic, and the blood flow was not detected. CDEUS 2 weeks after EIS showed thickness of the esophageal wall with a mild echogenic pattern. Four weeks after EIS, the esophageal varices were completely disappeared without any blood flow, and a 5-layer structure just like the normal eso-phageal wall was observed. Besides, CDEUS 4 weeks after EIS also revealed the complete resolusion of varices. Therefore, CDEUS after 4 weeks is suitable to evaluate the effect of EIS. EIS resulted in incomplete disappearance of the varices in 10 patients and complete disappearance in 16. Of these 10 patients with incomplete disappearance, 6 patients with paraesophageal collateral veins recurred within 13 months, while those with complete disappearance who had no paraesophageal collateral veins did not recur within 13 months except for one patient. These results suggested that the existence of paraesophageal collateral veins may play a crucial role in the recurrence of varices. We concluded CDEUS is useful for evaluating the efficacy of EIS.
