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Pleuropulmonary complications of esophageal variceal sclerotherapy with absolute alcohol
Author(s) -
SETHY PRADEEPTA K,
KOCHHAR RAKESH,
BEHERA DIGAMBAR,
BHASIN DEEPAK K,
RAJA KAISER,
SINGH KARTAR
Publication year - 2003
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2003.03094.x
Subject(s) - medicine , chest pain , vital capacity , sclerotherapy , pulmonary function testing , pleural effusion , anesthesia , surgery , lung , gastroenterology , lung function , diffusing capacity
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 (PaO 2 , PaCO 2 , pH, HCO 3 , SaO 2 ), chest X‐ray and pulmonary function tests (forced expiratory volume at 1 s (FEV 1 ), forced expiratory vital capacity (FVC), FEV 1 /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 FEV 1 after EVS as compared with baseline values. However, FEV 1 /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 FEV 1 and FVC without change in FEV 1 /FVC ratio after EVS, suggesting a restrictive type of defect.