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Rev. méd. Chile ; 127(6): 685-92, jun. 1999. tab
Article in Spanish | LILACS | ID: lil-245310

ABSTRACT

Background: Sclerosis, injection of cianoacrylate and rubber band ligation are the most commonly used endoscopic techniques for the treatment of bleeding esophageal varices. Aim: To assess the effectiveness of cianoacrylate and polidocanol in the treatment of bleeding esophageal varices. Patients and methods: Sixty eight patients with active variceal bleeding were studied. Bleeding varices were classified as thin, thick or gastric. Bleeding from thin varices was treated with polidocanol. Bleeding from thick or gastric varices was treated with cianoacrylate. Variceal erradication was done with polidocanol. Results: Bleeding came from thin esophageal varices in 23 percent of patients and endoscopic treatment stopped bleeding in 95 percent of them, from thick esophageal varices in 62 percent and endoscopic treatment was successful in 94 percent of these, and from gastric varices in 12 percent and treatment stopped bleeding in 87 percent of these (in 3 percent bleeding was considered subcardial). Twenty five percent of patients bled again during variceal erradication, 12 percent died due to uncontrollable bleeding and 20 percent died due to liver failure. During variceal erradication 59 percent of patients classified as Child Pugh C, died. Conclusions: Treatment of bleeding esophageal varices with cianoacrylate or polidocanol is effective. Patients classified as Child Pugh C have a bad prognosis


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Gastrointestinal Hemorrhage/etiology , Esophageal and Gastric Varices/complications , Cyanoacrylates/administration & dosage , Cyanoacrylates/pharmacology , Gastrointestinal Hemorrhage/drug therapy , Liver Cirrhosis/complications , Hepatic Insufficiency/complications , Endoscopy
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