Pleuropulmonary complications of esophageal variceal sclerotherapy with absolute alcohol

J Gastroenterol Hepatol. 2003 Aug;18(8):910-4. doi: 10.1046/j.1440-1746.2003.03094.x.

Abstract

Background: Esophageal variceal sclerotherapy (EVS) is an effective means of controlling variceal hemorrhage. However, it causes a wide variety of local and systemic complications. The present study was performed to document pleuropulmonary complications of EVS with absolute alcohol.

Methods: Twenty-six patients of portal hypertension of different etiologies were subjected to EVS with absolute alcohol. Baseline arterial blood gas analysis (PaO2, PaCO2, pH, HCO3, SaO2), chest X-ray and pulmonary function tests (forced expiratory volume at 1 s (FEV1), forced expiratory vital capacity (FVC), FEV1/FVC, maximum mid-expiratory flow rate (MMFR), and peak expiratory flow rate (PEFR)) were performed 4-6 h before the first session of EVS. These investigations were repeated within 24 h of EVS. Patients were asked to maintain a symptom diary and to record symptoms such as fever, chest pain, dysphagia and dyspnea during the study period.

Results: Ten patients (38.46%) had chest pain and four patients (15.68%) had fever after sclerotherapy. Eight patients (30.54%) complained of dyspnea and six patients (23.08%) developed pleural effusion. There was a significant decline in FVC and FEV1 after EVS as compared with baseline values. However, FEV1/FVC ratio, MMFR and PEFR did not have any significant change.

Conclusions: Chest pain (38.46%), dyspnea (30.54%) and fever (15.68%) were the common symptoms after EVS while chest X-ray showed pleural effusion in 23.08%. Pulmonary function tests revealed a significant decline in FEV1 and FVC without change in FEV1/FVC ratio after EVS, suggesting a restrictive type of defect.

MeSH terms

  • Adolescent
  • Adult
  • Blood Gas Analysis
  • Chest Pain / etiology
  • Chi-Square Distribution
  • Dyspnea / etiology
  • Esophageal and Gastric Varices / therapy*
  • Ethanol / adverse effects*
  • Female
  • Fever / etiology
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Pleural Effusion / etiology
  • Respiratory Function Tests*
  • Sclerotherapy / adverse effects*
  • Vital Capacity

Substances

  • Ethanol