ABSTRACT
This study was conducted to compare usual sclerosants [polidocanol 1%, ethanolamine oleate 5%] and the tissue adhesive [cyanoacrylate] in the control of esophageal variceal bleeding in Egyptian patients with portal hypertension in a prospective comparative trial. 60 patients with portal hypertension due to schistosomal hepatic fibrosis and/or post-hepatitic liver cirrhosis who had presented with acute esophageal variceal bleeding were enrolled. Patients received balloon tamponade prior to injection were excluded. Resuscitation had been done before or during emergency endoscopy. Emergency endoscopy was conducted within 2 hours from the onset of hematemesis. Patients were immediately randomized during emergency endoscopy to receive polidocanol 1%, ethanolamine oleate 5% or tissue adhesive. Variceal rebleeding was managed by reinjection. The 3 groups were comparable for age, sex, etiology of portal hypertension, Child-Pugh class and findings at emergency endoscopy. From the results obtained, it was concluded that polidocanol, ethanolamine and cyanoacrylate are equally safe and effective. For immediate endoscopic injection therapy, an experienced team must be available