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Leber, Magen, Darm 1976

[Technique of submucous sclerosing in patients with bleeding esophageal varices -- therapeutic results (author's transl)].

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O Kronberger
H Schnack
E Vyslonzil

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Abstract

Acute hemorrhage from esophageal varices is becoming more and more frequent, implying a poor prognosis for the patient and necessitating dramatic therapeutic procedures by the physician or the surgeon. Regular endoscopic controls of patients with liver cirrhosis and portal hypertension are necessary before the first bleeding occurs in spite of negative X-ray findings of the esophagus, since long-term therapeutic results may be inproved by such controls. Sclerosing the esophageal wall does not occlude the esophageal veins, which do remain open consequently; they are just "displaced" deeper into the mucosa. There are no risks or complications of this procedure especially when esophageal varices are just beginning to form and when the esophageal mucosa is still being intact. Therapeutic results are encouraging, and they are better as compared to the results of emergency shunt or elective shunt surgery. Until short time ago sclerosing the esophageal wall was sort of a preliminary preoperative therapeutic procedure. Today it is a well established therapy in its own right, although it is, as is shunt surgery, symptomatic therapy. It does seem to be superior however to all other forms of therapy aimed at preventing or treating esophageal bleeding, since primary mortality seems to be lower and longterm results seem to be better.

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