Injection sclerotherapy in adult patients with extrahepatic portal venous obstruction

Thirty-nine adult and teenage patients with extrahepatic portal venous obstruction (EHPVO) were treated with injection sclerotherapy. There were 22 males and 17 females with a mean age of 27 years (range 12-69). Oesophageal varices were eradicated in 33 patients after seven injections (range 1-17) over a mean of 14.5 months (range 1-48). Fewer injections were needed to eradicate varices in older patients. Variceal bleeding occurred on 13 occasions in 9 patients before eradication of varices and on 4 occasions in 4 of the 33 patients in whom varices had been eradicated, with a mean follow-up of 44 months (range 3-105). There were no deaths during the study period. Complications, mostly of a minor nature, occurred in 25 patients and included injection site leak in 5, stenosis in 7 and mucosal ulceration in 23. We conclude that injection sclerotherapy is the treatment of choice in patients with EHPVO.