Abstract
Endoscopic injection sclerotherapy (EIS) has become popular in the treatment of emergency cases of hematemesis. We report here the results of our study, mainly those of the emergency cases.
Of 75 patients subjected to EIS, emergency EIS (E-EIS) was performed on 23 cases in which EIS was done within 24 hours after the onset of bleeding. EIS was performed by intravenous injection of 5% ethanolamine oleate according to the procedure of Takase et al.
Of 23 cases subjected to E-EIS, successful hemostasis for more than one week was obtained in 22 cases (96%). Re-bleeding was seen in 5 cases (22%). No aggravation was seen just after the first E-EIS. Form factor (F) was highly improved in 63%. Location (L), F and red-color sign (RC sign) maintained the improved variceal conditions in 100%, 93%, and 85%, respectively. Eight patients died and death was not directly caused by bleeding from esophagel varices in any cases: the cause of death was hepatic insuffciency in 4 cases, hepatic insufficiency from hematemesis in 3 and intraperitoneal bleeding of hepatocellular carcinoma in one.
Thus, it is suggested that E-EIS is a very important method in treating the emergency cases of esophageal varices.
