This is a prospective study, carried out in patients with
portal hypertension and
bleeding oesophageal
varices secondary to Symmers (Schistosomal) periportal
fibroses, to determine the efficacy of
sclerotherapy, the number of sessions needed to achieve full
sclerosis, the complications associated with
sclerotherapy and the incidence and risk factors for rebleeding. In total, 85 patients were studied with a mean age of 38 years, 76.5% were males. All underwent upper gastrointestinal endoscopy, had different grades of oesophageal
varices and underwent intravariceal injection with 5%
ethanolamine oleate until they achieved full
sclerosis or were referred to surgery. Complications of
sclerotherapy included oesophageal
strictures, deep oesophageal
ulcers,
pleural effusion and
ascites. Following obliteration of oesophageal
varices, 3.5% and 20% developed new
gastric varices and portal gastropathy, respectively. Rebleeding occurred in 32% - the only significant predictive risk factor for which was patients with GIII
varices following the first
sclerotherapy session.
Varices recurred in 6% of patients after a mean follow-up period of one year. In total, 93% of our patients achieved full
sclerosis after an average of four sessions, and 3.5% were referred for surgery. Three patients (3.5%) died, all from massive rebleeding. In conclusion,
sclerotherapy is a safe effective method for treating patients with oesophageal
varices due to periportal
fibroses.