This study was carried out on 78 patients (68 males and 10 females)
who had bleeding oesophageal varices. The aim of the study was to compare
between sclerotherapy and the surgery of splenectomy and devascularization in
the management of bleeding oesophageal varices. All the patients after
resuscitation and clinical examination had full laboratory investigations,
abdominal ultrasonography then upper gastro-intestinal endoscopy. Patients
with Modified Child's A and B classification were randomly allocated into two
groups: group I including patients managed by sclero therapy and group II
including patients subjected to surgery. Bleeding was controlled in both groups
with insignificant statistical dfference, but complete eradication of the varices
was achieved in 86.3% in group I and in 32.3% in group Il which was
statistically significant Rebleeding occurred in 13.6% and 17.6%, ascites in
18% and 11.8%, encephalopathy in 4.5% and 5.9% and mortality in 15.6% and
20.6% for both groups respectively. These results were statistically
insignificant Liver biopsy was performed in 82% of the all patients and
denoted that bilharzial fibrosis with cirrhotic liver is the commonest etiological
factor (71.8%). .
It is considered that sclerotherapy is a good modality for managing
bleeding oesophageal varices and also for preventing rebleeding. |
