STUDIES ON THE EXTENT OF EMBOLIZATION OF BLOOD SUPPLY ROUTE BY INJECTION SCLEROTHERAPY FOR THE ESOPHAGEAL VARICES ASSOCIATED WITH GASTROPHRENIC SHUNT

Abstract

We studied the effect of injection sclerotherapy (IS) on 11 patients of esophageal varices associated with gastrophrenic shunt by comparing the endoscopic varicography (EV) and the percutaneous transhepatic portography (PTP) carried out 2 weeks before and after IS. EV was carried out with a mixture of sclerosant and contrast medium while performing the IS. The rate of visualization of the portal collateral pathway by EV was evaluated by comparing the PTP before IS. The rate of embolization of portal collateral pathway by IS was evaluated by comparing the PTPs before and after IS. The rate of visualization observed by EV for each collateral pathway was 100% for the esophageal varices, 89% for the fundic venous plexus, 45% for the left gastric vein, 22% for the short gastric vein, 44% for the paraesophageal vein, 18% for the phrenic vein, 0% for the pericardiac vein and 0% for the intercostal vein. The rate of embolization by IS for each collateral pathway was 100% for the eso-phageal varices, 89% for the f undic venous plexus, 9 % for the left gastric vein, 11% for the short gastric vein, 22% for the paraesophageal vein, 0% for the phrenic vein, 0 % for the pericardiac vein and 0 % for the intercostal vein. We conclude that the IS, for esophageal varices associated with gastrophrenic shunt, embolize the esophageal varices successfully and embolize the fundic venous plexus considerably, but it not embolize the gastrophrenic shunt at all.