Pleural effusions after endoscopic variceal sclerotherapy.

The prevalence of pleural effusions after endoscopic variceal sclerotherapy was reviewed in 30 patients undergoing 65 sclerotherapy sessions. Pleural effusions were identified radiographically after 31 of the 65 (48%) sclerotherapy sessions. Eleven of the effusions were right-sided, 10 were left-sided, and 10 were bilateral. Most of the effusions (20 of 31, 65%) were small. Significant postsclerotherapy chest pain was found more commonly in those patients who developed pleural effusions (11 of 31, 35%) compared with those who did not (4 of 34, 12%) (p less than 0.05). The total sclerosant volume injected was significantly greater in those who developed effusions (13.2 +/- 5.8 ml) (mean +/- SD) than in those who did not (8.5 +/- 4.5 ml) (p less than 0.001). Twelve effusions were analyzed biochemically after thoracentesis. Eleven effusions met one or more of three criteria commonly used to identify exudative effusions. We conclude that pleural effusions develop frequently after sclerotherapy. The effusions are predominantly exudative in character and presumably arise from inflammation of the mediastinal parietal pleura.