Morphologische Befunde am distalen Ösophagus nach Sklerosierung blutender Varizen

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Abstract
The morphological changes in the distal oesophagus occurring after tube treatment, sclerosis and/or shunt operation for acutely bleeding oesophageal varices were investigated in 29 post mortems between March 1979 and April 1980. In addition three oesophagi were investigated after sclerosis several months previously. As was to be expected the oesophagi showed no specific changes after recent porto-caval shunts. In contrast there were definite histological differences after tube treatment as opposed to sclerosis. After compression tubes the oesophagi showed focal pressure necroses and ulcers. In the sclerosed oesophagi there frequent widespread, partially transmural, necroses, suppurative inflammation of the oesophageal wall and mediastinitis. Serious complications occurring after sclerosis were perforation with mediastinal abscess, pleuritis and severe paraoesophageal haemorrhage. In the prevention of complications after sclerosis both the injection technique and the choice of sclerosing agent are important.

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