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Introduction:Lower end of the esophagus portosystemic anastomosis formed by Left gastric vein and Esophageal tributaries of accessory hemizygous vein. Although all these vessels contribute to the shunting of esophageal collaterals or varices, are the most important clinically, because of their predilection to bleeding. Sclerotherapy is associated with a wide range of complications ranging from transient pyrexia to esophageal perforation resulting in death. Complications following sclerotherapy depends on a number of factors namely nature of sclerosant used, amount of sclerosant, injection site, concentration of the drug and the time interval between the sessions. Material And Methods: A prospective and observation study on management of esophageal varices by endoscopic injection sclerotherapy using absolute alcohol as sclerosant has been done in Endoscopy Unit. The patients were admitted in various medicine, surgical and paediatric wards in our hospital. Endoscopy (Esophago Gastro Duodenoscopy) is the utmost important investigation to know the cause of upper gastrointestinal bleeding. If the bleeding is from the esophageal varices, then the grading of the esophageal varices has to be done and associated fundal varices, portal hypertensive gastropathy are noted. Patients with esophageal varices were subjected for endoscopic sclerotherapy using absolute alcohol, while performing the diagnostic endoscopy. Results: In our clinical observation study, 46 cases were selected. Out of these, the maximum number of cases was within the age group of 40-49 years. i.e. 15 cases (32.6%). The minimum age of the patient in our series was 6 years and the maximum age was 82 years. Total no. of sclerotherapy sessions required is 145. Out of 46 patients 5 patients undergone single sessions for obliteration, 3 patients undergoes two sessions, 15 patients undergone three sessions and 23 patients undergone four sessions of sclerotherapy. The total regression of esophageal varices was achieved in 37 patients (80.43%) and partial regression in 8 patients (17.4%) and no change in grade of varices in 1 patient (2.17%) with sclerotherapy using absolute alcohol.Conclusion: Sclerotherapy using absolute alcohol has yielded superior results as far as the control of acute bleeding, obliteration of varices is concerned but complication like esophageal ulcer is more. Sclerotherapy using absolute alcohol is very cost effective, economical, safe, and freely available. |
