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  • Title: Short-term effects of variceal sclerotherapy on portal hypertensive gastropathy.
    Author: Boldys H, Romanczyk T, Hartleb M, Nowak A.
    Journal: Endoscopy; 1996 Nov; 28(9):735-9. PubMed ID: 9007425.
    Abstract:
    BACKGROUND AND STUDY AIMS: Obliteration of esophageal varices may modify the mucosal perfusion of the stomach. The relationship between short-term injection variceal sclerotherapy (IVS) and the evolution of portal hypertensive gastropathy (PHG) is insufficiently recognized. PATIENTS AND METHODS: Forty-one cirrhotic patients were treated with hemostatic or secondary preventive IVS. They underwent sclerotherapy at intervals of four to five days until esophageal ulceration, stricture, or a reduction in variceal size developed. On admission and on completing the IVS schedule, an endoscopy score was calculated using a system assigning 0 points for a normal mucosal image, 1 point for reddened, 2 points for a mosaic-like mucosal pattern, and 3 points for a mosaic-like pattern plus red marks in the stomach. All patients received propranolol after the first sclerotherapy session. RESULTS: The total score before IVS was 45 points (1.1 points per patient). After 188 sclerotherapy sessions (2-8 per patient), the score significantly increased to 73 points (1.8 points per patient, P = 0.04). This effect was particularly marked in Child-Pugh class B patients (mean individual rise from 0.7 to 1.9 points, P = 0.01), and negligible in patients with either less or more advanced cirrhosis (Child-Pugh classes A and C). CONCLUSIONS: In patients with cirrhosis, short-term IVS may contribute to the mechanisms of progressive PHG.
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