polidocanol and Esophageal-Diseases

Topics: Ablation Techniques; Administration, Topical; Biopsy; Bronchogenic Cyst; Esophageal Diseases; Esophagoscopy; Humans; Male; Polidocanol; Sclerosing Solutions; Therapeutic Irrigation; Tomography, X-Ray Computed; Ultrasonography; Young Adult

Topics: Esophageal and Gastric Varices; Esophageal Diseases; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy

The aims of the present study were to evaluate, by means of impedance plainmetry, regional differences in biomechanical properties in the normal oesophagus and the oesophagus damaged by sclerotherapy.. Four minipigs underwent a weekly session of sclerotherapy for 4 weeks. Impedance planimetry was performed before the first session of sclerotherapy and 1 week after the last session of sclerotherapy. Investigations were performed by stepwise pressure-induced balloon distensions with concomitant measurements of pressure and luminal cross-sectional area (CSA) in the oesophagus 5 and 10 cm above the gastro-oesophageal junction (GEJ).. The normal oesophagus had significantly larger CSAs 5 cm than 10 cm above the GEJ (P < 0.05). Endoscopic sclerotherapy entailed an inversion (P < 0.05) of the normal oesophageal configuration, with narrowing 5 cm above the GEJ (P < 0.05) and increased CSAs 10 cm above the GEJ (P < 0.05).. Regional differences in CSA occur in the normal oesophagus, and sclerotherapy produces profound changes in the oesophageal configuration.

Topics: Animals; Biomechanical Phenomena; Edema; Electric Impedance; Electrodes; Electrodiagnosis; Esophageal Diseases; Esophagogastric Junction; Esophagoscopy; Esophagus; Female; Male; Polidocanol; Polyethylene Glycols; Pressure; Sclerosing Solutions; Sclerotherapy; Swine; Swine, Miniature; Ulcer

Human epidermal growth factor (EGF), a small polypeptide (6 kDa) with mitogenic properties, has been implicated in the protection of gastrointestinal mucosal integrity. The efficacy of EGF in the prevention and healing of sclerotherapy-induced esophageal lesions was investigated in 24 minipigs with surgically induced portal hypertension. In addition, the effect of EGF on intragastric acidity and pharmacokinetics was investigated as possible means to explain its protective mechanism of action. The animals underwent three weekly sessions of sclerotherapy with polidocanol 2% and were concomitantly and for an additional three weeks treated with either placebo or EGF administered paravenously in the esophagus and/or subcutaneously. The subcutaneous treatment with EGF significantly (P < 0.05) reduced esophageal stricture and scar formations associated with sclerotherapy. Gastric pH values were significantly (P < 0.01) elevated only in animals receiving subcutaneous injections of EGF. Furthermore, the subcutaneous administration of EGF was associated with unexpected prolonged plasma concentration of the peptide. These results suggest a possible clinical value of EGF as an adjunctive treatment with the sclerotherapy.

Topics: Animals; Epidermal Growth Factor; Esophageal Diseases; Esophageal Stenosis; Gastric Juice; Humans; Hydrogen-Ion Concentration; Male; Polidocanol; Polyethylene Glycols; Recombinant Proteins; Sclerosing Solutions; Sclerotherapy; Swine; Swine, Miniature; Ulcer

Topics: Aged; Esophageal and Gastric Varices; Esophageal Diseases; Hematoma; Humans; Male; Polidocanol; Polyethylene Glycols; Sclerosing Solutions

Two patients with cirrhosis are presented who developed retrosternal pain and dysphagia immediately after sclerotherapy of esophageal varices. Extensive submucosal bleeding of the esophageal wall was demonstrated radiologically and endoscopically. Complete resolution occurred spontaneously and did not lead to residual complications such as strictures. Intramural hematoma of the esophagus is an unusual complication after endoscopic variceal sclerotherapy.

Topics: Adult; Esophageal and Gastric Varices; Esophageal Diseases; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy

Topics: Esophageal and Gastric Varices; Esophageal Diseases; Esophageal Perforation; Humans; Male; Middle Aged; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Ulcer

A patient is described who developed severe retrosternal pain and dysphagia immediately after sclerotherapy of esophageal varices. Extensive submucosal bleeding of the esophageal wall was demonstrated radiologically and endoscopically. This lesion resolved within 2 weeks of conservative treatment.

Topics: Adult; Esophageal and Gastric Varices; Esophageal Diseases; Female; Gastrointestinal Hemorrhage; Hematoma; Humans; Polidocanol; Polyethylene Glycols; Radiography; Sclerosing Solutions