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ENDOSCOPIC INJECTION SCLEROTHERAPY FOR ESOPHAGEAL VARICES IN TWO PATIENTS WITH IDIOPATHIC MYELOFIBROSIS
Author(s) -
Sato Takahiro,
Yamazaki Katsu,
Toyota Jouji,
Karino Yoshiyasu,
Ohmura Takumi,
Akaike Jun,
Kuwata Yasuaki,
Suga Toshihiro
Publication year - 2004
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2004.00404.x
Subject(s) - medicine , gastric varices , esophageal varices , varices , varix , sclerotherapy , radiology , splenic vein , surgery , gastroenterology , portal hypertension , cirrhosis
Case 1: A 75‐year‐old woman was admitted to our department in February 1996 with tarry stool. At 71 years of age, she had been diagnosed with idiopathic myelofibrosis (IMF) based upon laboratory data and a biopsy of iliac bone marrow. Fibergastroscopic examination on admission revealed esophageal varices graded as Ls, F2, Cb, and red color (RC)(+ +). Esophageal varices were considered the most likely cause of the bleeding. Computed tomography (CT) showed a markedly enlarged spleen and large collateral veins (left gastric vein, spleno‐renal shunt). We performed endoscopic injection sclerotherapy (EIS) twice weekly using 5% ethanolamine oleate with iopamidol (5% EOI), the total amount of sclerosant was 13 mL. No further variceal bleeding occurred until she died in June 1996. Case 2: A 67‐year‐old man was admitted to our hospital in February 1992 with anemia and leukocytosis after a health check. He was diagnosed with IMF based upon laboratory data and a biopsy of iliac bone marrow. Screening upper gastrointestinal endoscopy demonstrated esophageal varices graded as Ls, F3, Cb, and red color (RC)(+) and gastric varices graded as Lg–cf, F2, and RC(–). CT showed a markedly enlarged spleen and large collateral veins (left gastric vein, short gastric vein). We performed EIS four times weekly using 5% EOI, the total amount of sclerosant was 32 mL. Two weeks after EIS the varices were graded as F1, RC(–). This patient experienced esophageal varix recurrence up to 1 year later, and EIS was performed twice using 5% EOI.