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Esophageal stricture due to endoscopic injection sclerotherapy for esophageal varices using 5 percent ethanolamine oleate



Esophageal stricture due to endoscopic injection sclerotherapy for esophageal varices using 5 percent ethanolamine oleate



Gastroenterological Endoscopy 31(4): 831-836



Recently, endoscopic injection sclerotherapy (EIS) has been considered to be an effective treatment for esophageal varices. Five percent ethanolamine oleate (5% EO) is an effective agent when injected intravaricerally, but when injected paravaricerally it produces various formed deep esophageal ulcers causing an esophageal stricture. Therefore, it is necessary to pay attention to the injection volume of EO. One hundred and eighty four cases of esophageal varices have been treated with EIS from November 1983 to December 1987. Seven cases of them (3.8%) had an esophageal stricture after EIS. EIS was performed by EOMA method, polidocanol method, and the combine method using both EO and polidocanol (EO-P) method. We studied these 7 cases from the view of injection volume of EO and the form of esophageal ulcerations produced by EO. The result was that most cases of such esophageal strictures were injected EO more than 10 ml at each EIS after the initial EIS and consequently had large esophageal ulcerations. For severe esophageal strictures, endoscopic dilatation therapy using pneumatic dilator was effective for improving the patients' complaints. From the result, it was thought that the injection volume of EO should be less than 10 ml at each EIS after initial EIS.

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