Dysphagia after prophylactic endoscopic injection sclerotherapy for oesophageal varices: Not fatal but a distressing complication

Background: Although dysphagia resulting from oesophageal strictures induced by endoscopic injection sclerotherapy (EIS) is not a fatal complication, it is often quite distressing for the patients. The aim of the current study was to clarify the relationship between dysphagia resulting from oesophageal stricture following prophylactic EIS and the volume of sclerosant consumed in the EIS series. Methods: Fifty-two patients with oesophageal varices, who had been treated by prophylactic EIS, were selected as the subjects. Results: Seventeen (32.7%) patients developed dysphagia following prophylactic EIS, and five patients with a severe stricture required bougie dilatation to take meals. The volume of sclerosant used in the initial session of EIS for patients with subsequent dysphagia (24.9 ± 4.0 mL) was significantly larger than that for patients without dysphagia (18.4 ± 5.1 mL; P < 0.001). The mean volume of sclerosant consumed per session during the EIS series for patients with dysphagia (16.5 ± 3.0 mL) was also significantly larger than that for patients without dysphagia (13.1 ± 3.8 mL; P < 0.01). Conclusions: The injection of a superfluous amount of sclerosant in prophylactic EIS brings about distressing dysphagia with oesophageal stricture in the patients with oesophageal varices who had no such complaint or symptoms before the therapy. (C) 2000 Blackwell Science Asia Pty Ltd.