Pathomorphological studies in the autopsy cases which survived long term after endoscopical injection sclerotherapy for esophageal varices
Arakawa, M.; Kage, M.; Inoue, R.; Okubo, K.; Shimotsuura, K.; Eguchi, S.; Nagata, K.; Toyonaga, A.
Gastroenterological Endoscopy 30(7): 1491-1497
Pathomorphological studies were performed in seven cases which achieved perfect eradication of varices comfirmed endoscopically and survived more than one year after endoscopic injection sclerotherapy. Three of them which showed perfect eradication of varices at autopsy had four occluded variceal veins by extensively organized thrombi with occasional recanalization. The other three cases had moderately dilated recanalized small vessels in the organized thrombus in the varices in the submucosa, and dilated variceal veins in the mucosa. These pathological findings were considered to be consistent with endoscopic findings of atypical red-color sign and telangiectasia. The remaining one case which developed reccurence of varices and died of bleeding from ruptured varices showed obvious varices at autopsy. These varices consisted of markedly dilated small vessels in the organized thrombi and dilated vessels around the varices. The description of this finding has never reported so far. Through the investigations on these cases, it was suggested that excessive intake of alcohol and deterioration of hepatocellular carcinoma found in 6 cases important factors to promote the reccurence of esophageal varices.