[Esophagogastric varix hemorrhage. Experience with cyanpoacrylate and polidocanol in 68 patients with active hemorrhage].
BACKGROUND: Sclerosis, injection of cianoacrylate and rubber band ligation are the most commonly used endoscopic techniques for the treatment of bleeding esophageal varices. AIM: To assess the effectiveness of cianoacrylate and polidocanol in the treatment of bleeding esophageal varices. PATIENTS AND METHODS: Sixty eight patients with active variceal bleeding were studied. Bleeding varices were classified as thin, thick or gastric. Bleeding from thin varices was treated with polidocanol. Bleeding from thick or gastric varices was treated with cianoacrylate. Variceal eradication was done with polidocanol. RESULTS: Bleeding came from thin esophageal varices in 23% of patients and endoscopic treatment stopped bleeding in 95% of them, from thick esophageal varices in 62% and endoscopic treatment was successful in 94% of these, and from gastric varices in 12% and treatment stopped bleeding in 87% of these (in 3% bleeding was considered subcardial). Twenty-five percent of patients bled again during variceal eradication, 12% died due to uncontrollable bleeding and 20% died due to liver failure. During variceal eradication 59% of patients classified as Child Pugh C, died. CONCLUSIONS: Treatment of bleeding esophageal varices with cianoacrylate or polidocanol is effective. Patients classified as Child Pugh C have a had prognosis.