Abstract
The purpose of this study was to elucidate the cause of the chest complications after endoscopic injection sclerotherapy (EIS) including esophago-bronchial fistula, pleural effusion, chest pain, and fever, and to consider a counterplan. Bronchofiberscopy was performed in 35 patients with portal hypertension before and after EIS. Before EIS, the bronchial venous dilatation, mainly in the left main bronchus, was found in various degree. The degree of bronchial venous dilatation correlated with form and location of esophageal varices, and subsided after EIS in a few patients. In 8 of 35 patients (22.9%), multiple small ulcerations appeared in the main bronchus after EIS. This bronchial ulceration did not correlate with total volume of sclerosant (1%polidocanol), hepatic reserve function classified by Pugh's score, esophageal ulcer after the first EIS, and minor complications as pleural effusion, chest pain, and fever. The causative factors seemed to be the direct effect of sclerosant, endoscopic examination itself, and the change of bronchial mucosal circulation during EIS. Bronchial ulceration was suggested to be local influence by EIS. These bronchof iberscopic findings are not generally unknown. The fact should be kept in mind and we must make an effort to detect these bronchial changes in their early stages and cope with these bronchial complications after EIS.
