Epidemiology

• Use: treatment of esophageal varices (see [[Esophageal Varices]])
• Agents
  • Sodium Morrhuate
  • Sodium Tetradecyl Sulfate
  • Ethanolamine Oleate
• Technique: usually, about 1 mL of the agents is injected in and around a varix -> total of 15-20 injections during a single procedure
• Incidence: CXR was abnormal in 85% of cases post-procedure in one series (but these were rarely clinically significant)

Adverse Effects

• Pleural Effusion (see [[Pleural Effusion-Exudate]])
  • Epidemiology
    • Occurs in approximately 25% of cases (range reported in literature: 0-50% of cases)
    • More common with larger number of injections and larger amount per injection
  • Diagnosis
    • CXR/Chest CT: pleural effusion
  • Clinical: usually asymptomatic
  • Treatment/Prognosis: usually resolve
• Mediastinal Widening/Mediastinitis (see [[Mediastinitis]])
  • Mediastinal widening occurs in 33% of cases
• Atelectasis (see [[Atelectasis]]): occurs in 12% of cases
• Pulmonary Infiltrates (see [[Pneumonia]]): occurs in 9% of cases
• Fever (see [[Fever]]): rarely significant
• Chest Pain (see [[Chest Pain]]): rarely significant
• Odynophagia (see [[Odynophagia]]): rarely significant
• Esophageal Perforation (see [[Esophageal Perforation]])
• Acute Lung Injury-ARDS (see [[Acute Lung Injury-ARDS]])
  • Epidemiology: occurs in <1% of patients

References