Bilharzial periportal fibrosis is the commonest cause of portal hypertension in Sudan. Injection sclerotherapy is the 1st option of therapy for the oesophago gastric varices because it is cheap and available.
It is more effective when used for rebleeding post Hassab operation, as proved in this study. Post Hassab rebleeders need less sessions and volume.
To document efficacy of scleroherapy in post Hassab operation rebleeding as less sessions of sclerotherapy are needed.
Retrospective study for 126 cases of injection sclerotherapy post Hassab operation in comparison to 100 cases treated with injection sclerotherapy only.
Direct collection of data from the follow up register in endoscopic department in Ibn Sina Hospital with the guide of the staff there
Majority of our patients were farmers and residentes of ElGezira which is the most endemic area with Bilharzia in Sudan.
More than 26 patients (12%) had a period of 10 years without symptoms or signs of rebleeding revealing the efficacy of Hassab operation.
Those who rebled after Hassab operation were easily
Controlled by few sessions of injection sclerotherapy
Both injection sclerotherapy and Hassab were partially effective in controlling of the bleeding individually. Combination was more effective with the evidence of those rebleeding post Hassab were easily controlled by less sessions and less volume sclerotherapy.
By using primary simple protective measures catastrophic bilharzial complications can be avoided.
If happen injection schlerotherapy and Hassab operation are more popular and effective in our culture and more suitable because of low cost and simplicity.
More comparative studies are needed in combination therapy both retrospective and prospective according to the state of the patients.