Emergency and long-term transesophageal sclerotherapy of bleeding esophageal varices. A prospective study of 50 consecutive cases.

Fifty consecutive unselected patients with endoscopically proven bleeding esophageal varices were on 76 occasions during 3 years treated with transesophageal sclerotherapy. One-week hemostasis was obtained in 89%, with a hospital mortality of 14%. Three major complications (1.1%) occurred, with one fatal outcome. Long-term repeated sclerotherapy was instituted according to our protocol in all the survivors. During a mean follow-up period of 26 months 19 patients have been treated with sclerotherapy alone, 10 had elective and 2 had emergency operative procedures because of rebleeding. Six fatal bleedings occurred, four after sclerotherapy alone. The 3-year survival is calculated to be 49%. Sclerotherapy has proven to be effective and safe and can be recommended especially in the acute situation. It can also be used as long-term treatment, but rebleedings will in several cases necessitate operative procedures.