Radiology, Vol 153, 43-47, Copyright © 1984 by Radiological Society of North America
The esophagus after injection sclerotherapy of varices: immediate postoperative changes
DP Tihansky, JJ Reilly, RR Schade and DH Van Thiel
Following the endoscopic injection sclerosis (EIS) of esophageal varices,
radiographic procedures heretofore have played a minimal role in the
dynamic assessment of structural and physiological alterations of the
esophagus. This study includes a control esophagogram of each patient
before any treatment. Esophageal studies were performed both before and
after barium ingestion within a few hours of the treatment session, and
findings were contrasted with those of the control esophagography and
correlated with those of endoscopy. In all patients, immediately after EIS
there was marked narrowing along the distal esophagus with both an upwardly
convex border or shoulder effect at the sites of injection and variceal
thrombosis. Functional changes of weakened peristalsis or achalasia evolved
after early treatment sessions. Delayed emptying of the contrast-medium
bolus was observed above the stricture and occasionally in the more
proximal esophagus. The radiographic findings demonstrate the immediate
sequela of transient dysphagia and the more long term complications of
fibrosis and stricture.
