Esophageal variceal sclerosis.

In one year, we have performed esophageal varix sclerosis upon 20 patients with portal hypertension and bleeding esophageal varices who were not candidates for portosystemic shunting. The flexible fiberoptic endoscope permits sclerosis of both gastric and esophageal varices and is less prone to serious complications than the rigid instrument. Repeated injections are necessary to control hemorrhage. Five of nine acute episodes were successfully controlled. Fifteen patients survived initial hospitalization and entered a chronic injection protocol. Sclerosis has controlled recurrent variceal bleeding in 13 of this group. We now use injection sclerosis as the primary form of therapy for patients who have bled from esophageal varices. Portosystemic shunting is reserved for those instances of sclerotherapy failures.