Last reviewed dd mmm yyyy. Last edited dd mmm yyyy
Oesophageal varices can be very effectively treated by targeted sclerosis.
A flexible endoscope is manipulated to the site in the oesophagus where the varices are visualised. Using a dedicated needle, 1-3ml of sclerosant is injected into each varix, working from the widest area of expansion and moving in small steps proximally.
No compression of the site is required - radial force may actually disperse sclerosant. Eye protection against the sclerosant - sodium tetradecyl sulphate or ethanolamine oleate - must be worn by the operator and assistant.
Sclerosis is usually repeated at an interval of a week until obliteration is evident.
Evidence shows that the use of a vasoactive drug (e.g. somatostatin or octreotide) in combination with endoscopic treatment is more effective than either alone in controlling the initial variceal bleed (1).
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