抄録
From 1986 through 2007, endoscopic injection sclerotherapy (EIS) was performed in 67 patients with gastric varices. The total number of treatment sessions was 213: emergency treatment, 16; elective treatment, 125; and prophylactic treatment, 72. Hemostasis was successfully achieved by EIS with Histoacryl blue® in all patients who received emergency treatment. Good outcomes were also obtained in patients who underwent elective treatment and prophylactic treatment. The rate of recurrent bleeding was low.
Esophageal varices may occur together with gastric varices. These varices serve as a collateral shunt from the portal venous system to the azygos vein and superior vena cava and drain into the left renal vein and inferior vena cava through the adrenal vein. Therefore, gastric varices should be treated at the same time as esophageal varices whenever possible.
Sclerotherapy for gastric varices should be performed cautiously, bearing in mind that some varices have a rapid flow rate and large blood volume and that that blood flow cannot be blocked with an endoscopic balloon.
EIS with sclerosants and Histoacryl is usually performed for the emergency treatment of actively bleeding gastric varices. EIS is also useful as follow-up treatment to ensure complete eradication of varices. It is important to completely eradicate gastric varices. The goals of treatment for gastric varices are complete eradication and the prevention of recurrence, similar to esophageal varices.
