What is variceal sclerotherapy?
BACKGROUND. Endoscopic sclerotherapy, a well-established treatment for bleeding GI varices, accomplishes vascular obliteration by injection of a sclerosing agent. Crafoord and Frenckner introduced the concept in 1939, by using quinine to scle- rose bleeding esophageal varices.
Which technique is suitable for esophageal varices?
A procedure called upper gastrointestinal endoscopy is the preferred method of screening for esophageal varices. Your doctor inserts a thin, flexible, lighted tube (endoscope) through your mouth and into your esophagus, stomach and the beginning of your small intestine (duodenum).
What is endoscopic injection sclerotherapy?
Endoscopic sclerotherapy (EST) is performed by injection of a sclerosant into varices that produce variceal thrombosis and obliteration.
What is the recommended treatment for active variceal hemorrhage?
The current treatment options for acute variceal hemorrhage include medications (vasopressin, somatostatin, and their analogs), endoscopy, transjugular intrahepatic portosystemic shunt placement, and surgery.
What is a sclerotherapy procedure?
Sclerotherapy effectively treats varicose and spider veins. It’s often considered the treatment of choice for small varicose veins. Sclerotherapy involves injecting a solution directly into the vein. The sclerotherapy solution causes the vein to scar, forcing blood to reroute through healthier veins.
What drug is used for sclerotherapy?
The most commonly used agents are hypertonic saline, sodium tetradecyl sulfate, polidocanol, and chromated glycerin. Hypertonic saline 23.4% concentration is approved by the US Food and Drug Administration (FDA), but its use in sclerotherapy is off label.
What is endoscopic banding?
Endoscopic variceal ligation, or endoscopic band ligation, is a procedure that uses elastic bands to treat enlarged veins, or varices, in your esophagus. These abnormal veins develop in the esophagus and have thin walls with high blood pressure running through them.
What is the priority if varices are bleeding?
Obtaining hemodynamic stability should be the first priority in patients with acute bleeding; however, in patients with variceal bleeding, excess administration of fluids or transfusions may cause complications such as ascites or pulmonary edema owing to the underlying deterioration in liver function.
How do you stop bleeding from varices?
Beta blockers — Beta blockers, which are traditionally used to treat high blood pressure, are the most commonly recommended medication to prevent bleeding from varices. Beta blockers decrease pressure inside of the varices, which can reduce the risk of bleeding by 45 to 50 percent [1].
What are the dangers of sclerotherapy?
These include:
- Inflammation. This is usually mild but may cause swelling, warmth and discomfort around the injection site.
- Blood clot. A lump of clotted blood may form in a treated vein that may require drainage.
- Air bubbles. Tiny air bubbles may rise in your bloodstream.
- Allergic reaction.
What are the side effects of sclerotherapy?
Common side effects of sclerotherapy include: bruising. stinging. swelling….More serious side effects include:
- allergic reaction to the sclerosing agent.
- skin ulceration around the injection site.
- blood clots in the treated veins.
- discomfort around the injection site, caused by inflammation.
- infection in the skin.
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