Markers of potential esophageal variceal rebleeding in cirrhotic patients undergoing endoscopic injection sclerotherapy

Abstract

Endoscopic injection sclerotherapy has proven to be effective in reducing the severity of bleeding from esophageal varices in cirrhotic patients. However, rebleeding occurs in certain patients, and this can affect their long-term survival. Therefore, to evaluate varices that were likely to rebleed, the relationship between esophageal variceal re-bleeding and endoscopic variceal findings at the time of the initial injection scierotherapy were investigated, in cirrhotic patients. Sixty-three patients were investigated; they were assigned to three groups according to their Child's classification: A, B, and C. After the initial scierotherapy, rebleeding occurred in 14 patients (22%), specifically in 5% of those in group A, in 16% of those in group B, and in 47% of those in group C. The endoscopie findings at the time of the initial scierotherapy revealed that redness of the varices was most intense in the group C patients. Patients in whom the varices were intensely red and/or were located up to the level of the tracheal bifurcation were found to be the most likely to rebleed. Therefore, to prevent rebleeding in patients manifesting these signs, careful monitoring and repeated endoscopie injection scierotherapy is recommended.