polidocanol and Bezoars

Gastric bezoars were observed after esophageal variceal injection of polidocanol in 5 of 56 patients with alcoholic cirrhosis treated by endoscopic sclerosis. We suggest that endoscopic sclerotherapy could have induced a transient vagal injury resulting in delayed gastric emptying and subsequent bezoar formation. Although the volume of sclerosant (25-35 ml per session) and the length of the injector needle (4 mm) were the same in all patients, two reasons could explain the occurrence of bezoars in these five patients: a deeper injection of sclerosant, and a worsening of a preexistent vagal neuropathy due to diabetes mellitus and/or alcoholism.

Topics: Adult; Aged; Bezoars; Esophageal and Gastric Varices; Esophagoscopy; Female; Gastric Emptying; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Radiography; Sclerosing Solutions; Stomach; Vagus Nerve