ABSTRACT
Esophageal varices are a common feature of portal hypertension due to various etiologies. The esophageal epithelium may be directly attached to the wall of these dilated veins without any intermediate fibrous stratum seen on histological sections. The factors leading to the onset of hemorrhage from esophageal varices remain controversial. Since distal esophageal varices are mainly confined to the mucosa, the portal-systemic collateral system is significantly reduced by this technique. Barsoum and associates also investigated questionable obliteration of gastric varices by injecting collaterals at the esophageal level. The endoscope is brought back into the esophagus and the inflated balloon retracted to compress the gastroesophageal junction. Endoscopic sclerotherapy of bleeding esophageal varices has been performed for more than 40 years. In uncontrolled studies, it has been effective in controlling acute hemorrhage and in preventing recurrent bleeds. Controlled trials of acute and elective treatment are necessary to finally assess the value of this method.
