Pathological Studies on Esophageal Varices Treated with Injection Sclerotherapy

Injection sclerotherapy is one of the most effective treatments for esophageal varices. To investigate the fate of esophageal varices embolized with a sclerosant (ethanolamine oleate), we have examined at autopsy the esophageal wall of 14 patients with esophageal varices. When the sclerosant was injected into the varices, at first thrombi formed. After two weeks, granulation tissue appeared and the thrombi were gradually replaced. The granulation tissues were organized slowly after 3 months and in the organized granulation tissue, microscopic recanalization of vessels were seen in 8 out of 9 cases. There was no recurrence of the original varices and de novo varices occurred in one patient. These observations indicate that the varices embolized with ethanolamine oleate become organized in three months after the treatment, and accordingly the esophageal varices are cured. It became also clear that recurrence of the original varices did not occur after the organization.