Computed Tomography following Endoscopic Sclerotherapy of Esophageal Varices

Computed tomography of the chest following endoscopic injection sclerotherapy for esophageal varices was performed in 17 procedures in 13 patients. CT scans were obtained before and within 48 hours after the procedure. CT findings included: esophageal wall thickening; a low-attenuating lesion within the wall of the esophagus with varying appearances, either laminated, localized, or inhomogeneous; a mediastinal lesion; pleural effusion; and various types of pulmonary changes such as atelectasis, pleural-based lesions, dilatation of peripheral pulmonary vessels, and nodular lesions. However, on follow-up CT they had regressed or disappeared. The changes in the mediastinum and pleural space might be caused by direct extension of inflammation from the esophagus, but those in the lungs, especially dilatation of peripheral vessels, may be caused by the sclerosing agent passing to the pulmonary vessels.