Injection sclerotherapy for the management of esophageal and gastric varices

The development of esophageal and gastric varices is an important complication of portal hypertension with significant morbidity and mortality. Endoscopic variceal sclerotherapy (EVS) was the first and, for many years, the only successful endoscopic method available for the treatment of bleeding varices. Endoscopic variceal ligation (EVL) has since replaced EVS, except in certain situations where EVL is unavailable or not technically feasible. In these instances, EVS, when performed correctly, is a proven and effective method of controlling acute hemorrhage. Endoscopists performing sclerotherapy should be well aware of the multitude of common and potentially serious complications of EVS, so that the risks of these complications can be minimized.