Endoscopic Sclerotherapy for Esophageal Varices
Excerpt
Endoscopic sclerotherapy is a procedure to treat bleeding esophageal varices and prevent future variceal bleeding. The procedure involves the passage of an esophagoscope and injection of a sclerosing agent into or around esophageal varices. The mechanisms by which injection sclerotherapy controls variceal hemorrhage are not understood completely but are thought to involve damage to the intima, intraluminal thrombosis, and intravascular fibrous organization (1-7).
Important questions on the appropriate use of endoscopic sclerotherapy are unresolved. There is disagreement on the indications for treatment; type of esophagoscope and anesthetic to use; type and volume of sclerosing agent to use; adjunctive supportive measures;
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgments
ACKNOWLEDGMENTS: The Clinical Efficacy Assessment Project (CEAP) of the American College of Physicians is designed to evaluate and inform College members and others about the safety and efficacy of diagnostic and therapeutic modalities. Evaluation of technologies begins with a notice in the Annals of Internal Medicine and the ACP Observer inviting comments. Appropriate members of the Council of Medical Societies and the Council of Subspecialty Societies as well as other experts are asked to review technologies. The CEAP statements thus represent a synthesis of the literature and expert opinion and are intended to reflect the current state-of-the-art knowledge concerning a technology. Statements may be reconsidered as new information becomes available.
Article and Author Information
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↵* This paper was authored by Peter M. Marzuk, M.D., and J. Sanford Schwartz, M.D., and was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Donald E. Olson, M.D., Chairman; David Banta, M.D.; Alvan R. Feinstein, M.D.; Howard S. Frazier, M.D.; Richard B. Hornick, M.D.; and Seymour Perry, M.D. Members of the Health and Public Policy Committee for the 1983-1984 term were Edwin P. Maynard, III, M.D., Chairman; Arthur J. Atkinson, Jr., M.D.; Steven C. Beering, M.D.; Richard G. Farmer, M.D.; Paul F. Griner, M.D.; John R. Hogness, M.D.; Charles E. Lewis, M.D.; Donald E. Olson, M.D.; Malcolm L. Peterson, M.D.; Theodore B. Schwartz, M.D.; and Helen L. Smits, M.D. Richard J. Reitemeier, M.D., and Francis J. Sweeney, Jr., M.D., were ex officio members. This position paper was adopted by the Executive Committee of the Board of Regents on 16 January 1984.
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Grant support: The Clinical Efficacy Assessment Project is funded by the John A. Hartford Foundation.
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▸Requests for reprints should be addressed to Linda Johnson White; Clinical Efficacy Assessment Project, Department of Health and Public Policy, American College of Physicians, 4200 Pine Street; Philadelphia, PA 19104.
- © 1984 American College of Physicians
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