CLINICAL FINDINGS AND TREATMENT OF ESOPHAGEAL VARICES IN THE PATIENTS WITH HEPATOCELLULAR CARCINOMA

• Published in: Japanese Journal of National Medical Services Vol. 47; no. 9; pp. 655 - 660
• Main Authors: SAOSHIRO, Takeo, HONDA, Sanpei, NAKAYAMA, Hidetsugu, NISHIMAKI, Eiji, KAWAGUCHI, Misao
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1993
• Subjects: esophageal varices; hepatocellular carcinoma; injection sclerotherapy
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.47.655

Fifty-one patients with hepatocellular carcinoma were examined for esophageal varices by endoscopy. Then, the endoscopic findings were classified into 4 stages based on the score of F and the RC factors. Twenty-five cases (49%) had an F score of 2 or more or were positive for RC, and had potentially hemorrhagic esophageal varices. Hemorrhage was detected in seven out of these 25 patients, i. e., 14% of the total. The severity of endoscopic findings was correlated with that of the hepatic cancer and the clinical condition of the patient. However, no relationship was observed in a few cases. Among the patients who presented concomitant pylethrombosis, marked varices were found in 73% of the cases and hemorrhage was seen in 60% of them. Thirteen cases were treated with endoscopic injection sclerotherapy (EIS), which proved remarkably effective in 31%, moderately effective in 46%, and ineffective in 23%. All the patients who responded well to EIS were in the stage I or less of hepatic cancer. The patients with concomitant pylethrombosis and portal tumor were highly hemorrhagic, and many of them refused EIS treatment.