Histological findings of the esophagus in three autopsy cases which survived relatively long term after endoscopical sclerotherapy for esophageal varices.

概要

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There have been a few reports about the autopsy findings after the sclerotherpy for esophageal varices. We have experienced 3 patients who died long after the sclerotherapy; 2 of them whose esophageal varices had been in healing stage for 5 or 6 months following the sclerotherapy died myeloma and esophageal carcinoma, respectively, and the other one died of reccurence of esophageal varices 13 months after the therapy. Pathomorphological examination revealed that extensive organized thrombi with occasional recanalization in the veins were observed in 2 cases. The cases in which the reccurence occured had varices associated with partial intimal thickening. In addition, the range of fibrosis extended from the muscle layer toward the adventitia. These findings suggested that the sclerotherapy gave affecetions to the muscle layer and the adventitia even in the cases in which the therapy seemed to be extremely successful from clinical point of view. We discussed the efficacy and the side effects of the sclerotherapy based on the findings in the patients died soon after the therapy and the findings described above, and also gave consideration to the process of disappearance and reccurence of the varices.
社団法人日本肝臓学会の論文