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Symptomatic hemorrhoids and anorectal varices in children with portal hypertension
N D Heaton1, M Davenport, E R Howard
1Department of Surgery, King's Hill Hospital, London, England.
Insights
Few children experience anorectal issues, but portal hypertension increases risks. This study found symptomatic hemorrhoids and rectal varices in 4.2% of pediatric patients, treatable with injection sclerotherapy.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Colorectal Surgery
Background:
- Anorectal problems are infrequently reported in children with portal hypertension.
- Esophageal varices due to portal hypertension are a known complication in pediatric patients.
Purpose of the Study:
- To determine the incidence of anorectal symptoms in children with portal hypertension.
- To evaluate the outcomes of treatment for these symptoms.
Main Methods:
- Retrospective study of 189 pediatric patients undergoing injection sclerotherapy for esophageal varices.
- Data collected on anorectal symptoms, proctoscopic findings, and treatment interventions.
Main Results:
- The incidence of symptomatic hemorrhoids and rectal varices was 4.2%.
- Hemorrhoids are generally rare in children, suggesting a link to portal hypertension.
- Injection sclerotherapy proved effective for the majority of symptomatic cases.
Conclusions:
- Portal hypertension is associated with an increased incidence of anorectal symptoms in children.
- Symptomatic hemorrhoids and rectal varices in this population warrant consideration.
- Injection sclerotherapy is a recommended and effective treatment for symptomatic anorectal varices in children.
Abstract:
There have been few reports of the anorectal problems encountered in children with portal hypertension. We report the incidence of anorectal symptoms in a retrospective study of 189 children treated by injection sclerotherapy for esophageal varices secondary to portal hypertension. Anorectal symptoms, proctoscopic findings and treatment have been recorded in this group. The incidence of symptomatic hemorrhoids and rectal varices was 4.2%. Hemorrhoids are rare in children and the increased incidence can be assumed to be secondary to portal hypertension. Treatment is advised only for symptomatic patients and injection sclerotherapy is satisfactory for the majority.