An observational study on oesophageal variceal endoscopic injection sclerotherapy in patients with portal hypertension seen at the Centre for Clinical Research, Kenya Medical Research Institute

Abstract

Bleeding oesophageal varices still remain a common cause of significant morbidity and mortality in Kenya and is the leading cause of upper gastrointestinal haemorrhage as seen at Kenyatta National Hospital, Nairobi. We report on our experiences in the management of oesophageal varices using injection sclerotherapy. The study site was the Centre for Clinical Research, Kenya Medical Research Institute (KEMRI). Records from structured reporting on procedures and findings during oesophageal variceal injection sclerotherapy were reviewed. All the patients with portal hypertension and previous history of acute variceal blood who underwent endoscopic injection sclerotherapy between August 1998 and May 2001 in the endoscopy unit, KEMRI, had between 2 and 8 sessions of sclerotherapy with 10-15 ml of 5% ethanolamine oleate during each session. The injection sclerotherapy was done under sedation and pharyngeal local anaesthesia. This was followed by regular surveillance endoscopic examination at 1,3,6 months then yearly. A total of 112 patients underwent vericeal injection sclerotherapy. Male: Female of 2:2:1 and mean age was 32.8 ± 3.3 years. Eighty-five (75.9%) of the patients received at least 4 sessions of injections sclerotherapy. 82.4% of those who received sclerotherapy upto 4 sessions had regression of varices and 15% of patients' required more than 6 sessions. The report concludes that variceal injection sclerotherapy is a useful method of treating oesophageal varices and can be performed on an out patient basis.

African Journal of Health Sciences Vol. 14 (3-4) 2007: pp. 216-218