Radiology, Vol 124, 313-323, Copyright © 1977 by Radiological Society of North America
New techniques for interruption of gastroesophageal venous blood flow
R Pereias, M Viamonte Jr, E Russell, J LePage, P White and D Hutson
Enlarged gastroesophageal veins were successfully obliterated in 41
patients using embolization with modified autogenous clots and/or Gelfoam,
balloon occlusion, iatrogenic perivenous hematoma, sclerosing agents
(Sotradecol and Keflin), or a combination of these methods. Thirteen
patients were actively bleeding when studied, and the site of bleeding was
detected in 4. Surgical exploration of 16 patients and autopsy study of 5
showed persistent obliteration ranging between three weeks and seven
months. No major complications requiring reparative surgery were
encountered. Gelfoam soaked with Sotradecol is the preferred agent because
it provides persistent obliteration of the embolized veins. Patients who
are acutely bleeding or have done so previously are candidates for
selective obliteration of the gastroesophageal veins.
