Respiratory Functions and Cardiopulmonary Dynamics before and after Esophageal Variceal Sclerotherapy
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This study was done to evaluate if routine elective injection sclerotherapy of esophageal varices is associated with any deterioration in respiratory function and pulmonary haemodynamics after procedure and if any changes occur after sclerotherapy in platelet and leukocytic counts. The study was carried out on 50 patients with liver cirrhosis and portal hypertension. They were classified into 3 groups. Group A included 20 patients treated with injection sclerotherapy, group B included 20 patients who completed the schedule of injection sclerotherapy and group C (control group) 10 patients who were without history of bleeding or injection sclerotherapy. For all patients full clinical examination, liver function tests abdominal ultrasonography, respiratory function test (PVC), arterial blood gases, WBCs and platelet counts were done. Echocardiography was also done, in group A these tests were done one day before and one day after procedure except echocardiography was done 3 months after sclerotherapy. The results showed that forced vital capacity arterial 02 tension and oxygen saturation were significantly lower one day after sclerotherapy, than before sclerotherapy with no significant echocardiographic changes. These findings can be explained by embolization of sclerosant to the lung. The study showed also transient rise in W.B.Sc. and platelet counts one day after sclerotherapy which disappear after completing schedule of sclerotherapy. The study showed no significant echocardiographic changes before or after injection sclerotherapy. Patients undergoing esophageal variceal sclerotherapy develop restrictive defect in respiratory function one day of after the procedure detected by decrease in arterial 02 tension, oxygen saturation and forced vital capacity this may be due to embolization of the sclerosant to the lung.