Esophageal Varices Treated with Endoscopic Injection SclerotherapyA Pathological Study

摘要

Pathomorphological studies were undertaken on the gastro-esophageal wall to examine the change of esophageal varices following endoscopic injection sclerotherapy (EIS) in 18 patients. Thrombus formation of various degrees was observed in 17 of the 18 cases. Red thrombus was the main thrombus when death occurred within 22 days after EIS, and when the patient was alive for a considerably longer time after the therapy, an organized thrombus was usually seen with partial recanalization. The change in the esophageal wall was less striking with the intravariceal method by Ethanolamine Oleate than with para-variceal method by Paoscle (5 % Phenol Almond Oil) ; but the lesions, such as ulcers and necrosis, reached to the muscle layer or the tunica adventitia in some cases which had been treated by the intravariceal method. Fibrosis may then have taken place to cause esophageal stricture. Edema, inflammatory cell infiltration and ulcer formation in the submucosal layer were seen in the cases which died in an early period after the treatment. These lesions seemed to have favorable effects, promoting thrombus formation and retarding recanalization of the organized thrombus.