DR. MWANGI PETER WAMBUGU

I n an on-going clinical trial 12 patients with upper gastrointestinal haemorrhage due to oesophageal varices have undergone injection sclerotherapy. Another 5 have been followed up on conservative management. Of the sclerosed group 8, had schistosoma! disease, J cirrhosis of the liver while I had portal vein thrombosis. Three of the controls had schistosomiasis and 2 had cirrhosis. All of them were in Child's Classfication A or B. Sclerotherapy effectively stopped acute bleeding in all cases reducing further transfusions and hospital visits although 2 cases have been lust to follow-up and 3 have had repeat scler otherapy within 3 months, of initial management. Three art! alive and well. whereas I died ofa bout of haem ate me sis in the absence of the authors. A cast of 14-Jear-old boy who has had portal hypertension since birth and has had 2 shunt operations and oesophagectomy following which sclerothe rapy has been done is highlighted. Of the 5 control groups 2 patients have died due to bleeding varices within one year of follow-up, 1 patient has had to be changed to sclerotherapy as a life saving manoeuvre, however, the remaining 2 are a live and well on conservative management but have high rebleeding rates.