الفهرس 
Introduction
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Abstract
Introduction: In patients with portal hypertension the azygos vein plays an important role as a major drainage system for porto-systemic collateral circulation.
So, measurement of azygos blood flow (AzBF) is an index of blood flow through gastro-esophageal collateral blood vessels and esophageal varices.
The results of the previous studies about the effect of endoscopic treatment of esophageal varices on the azygos blood flow were contradicting.
Aim of The work: We undertook this randomized prospective work to study the changes in the azygos blood flow and the superior portosystemic collateral circulation before and after obliteration of esophageal varices by injection sclerotherapy versus band ligation using the endoscopic ultrasonography.
Patients and Methods: This study was conducted on 70 patients admitted to the hematemesis and melena unit in Mansoura Emergency Hospital. They presented with first attack of hematemesis and or melena due to bleeding esophageal varices. Our patients were randomized into two groups:
Group I (Endoscopic sclerotherapy):They underwent endoscopic sclerotherapy by Ethanol amine oleate 5%.
Group II (Endoscopic band ligation): They underwent endoscopic band ligation.
All our patients were subjected to, thorough history taking, clinical examination, laboratory investigations and abdominal ultrasound.
Endoscopic ultrasound was done 1-2 weeks after the first endoscopic session and after variceal obliteration in gastrointestinal endoscopy unit in Mansoura Specialized Medical Hospital. We identified the esophageal collaterals and perforators. We also measured , the azygos vein diameter and azygos blood velocity with estimation of the azygos blood flow.
Results: Esophageal collaterals may increased, decreased, or not changed after obliteration of esophageal varices with no difference between sclerotherapy and band ligation.
Both sclerotherapy and band ligation are highly effective in obliteration of esophageal perforators.
Azygos blood flow is not correlated to Child-Pough classification, grade of esophageal varices, or presence of gastric varices.
Azygos blood flow may be increased, decreased, or not changed after obliteration of esophageal varices with no difference between sclerotherapy and band ligation.