AI Article Synopsis
- Oesophageal varices are a major cause of upper gastrointestinal bleeding in Sudan, and endoscopic injection sclerotherapy (EST) is an effective treatment option, especially when other treatments are not available or are expensive.
- A retrospective study over 10 years analyzed 1,070 patients with bleeding varices primarily due to portal hypertension, highlighting that most cases were linked to schistosomal periportal fibrosis.
- The results indicate that EST is a practical and affordable approach for managing this condition, with a significant percentage of patients achieving complete sclerosis of varices after multiple treatment sessions.
Article Abstract
Introduction: Bleeding due to oesophageal varices is the commonest cause of upper gastrointestinal tract haemorrhage in Sudan. Endoscopic injection sclerotherapy (EST) is a valuable therapeutic modality for the management of variceal bleeding. Other options for treatment such as variceal banding are either expensive or unavailable.
Study Aims: A retrospective study to evaluate the outcome of EST in the management of bleeding oesophageal varices due to portal hypertension in a developing country (Sudan).
Patients And Methods: A total of 1070 patients over a period of 10 years (1986-1996) were studied. Inclusion criteria was bleeding oesophageal varices consequent to portal hypertension. EST was performed using a standard technique. Ethanolamine oleate 5% was the sclerosing agent utilized. The procedure was done on a day- case basis.
Results: There were 904 males (84.5%) and 166 females (15.5%). The cause of portal hypertension was schistosomal periportal fibrosis (PPF) in 999 (93.3%) patients, liver cirrhosis 59 (5.5%), mixed PPF and cirrhosis 5 (0.46%), portal vein thrombosis 6 (0.64%) and congenital hepatic fibrosis was present in 1 patient. A total of 100 (9.4%) patients presented with bleeding which occurred after surgery. Full obliteration of varices required a mean of 4 sessions with a range of 2-6. 462 (43.2%) have been followed up until complete sclerosis of varices.
Conclusion: This study provides evidence that endoscopic injection sclerotherapy is an essential component in the management of bleeding oesophageal varices caused by portal hypertension. It is a feasible and a cost-effective therapeutic strategy in developing countries.
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