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Evaluation of endoscopic secondary prophylaxis in children and adolescents with esophageal varices

Júlio Rocha Pimenta1, Alexandre Rodrigues Ferreira1,2, Eleonora Druve Tavares Fagundes1,2

  • 1Setor de Gastroenterologia Pediátrica do Hospital das Clínicas da Faculdade de Medicina da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.

Arquivos De Gastroenterologia
|January 13, 2017
PubMed

Insights

Endoscopic secondary prophylaxis effectively prevents upper gastrointestinal bleeding in children with esophageal varices. Band ligation showed lower rebleeding rates and fewer sessions needed for eradication compared to sclerotherapy.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Endoscopic Interventions

Background:

  • Esophageal varices bleeding is a major cause of mortality in portal hypertension.
  • Limited studies exist on secondary prophylaxis for esophageal varices in pediatric populations.

Purpose of the Study:

  • To assess the efficacy of endoscopic secondary prophylaxis in preventing upper gastrointestinal bleeding.
  • To evaluate outcomes in children and adolescents with esophageal varices.

Main Methods:

  • Prospective analysis of 85 pediatric patients with portal hypertension.
  • Endoscopic secondary prophylaxis using sclerotherapy or band ligation.
  • Evaluation of variceal eradication, rebleeding, gastric varices, and portal hypertensive gastropathy.

Main Results:

  • Esophageal varices eradicated in 81.2% after a median of four sessions.
  • Rebleeding occurred in 42.3% of patients, more frequently with sclerotherapy.
  • Band ligation demonstrated lower rebleeding rates (26.5%) and fewer sessions needed.

Conclusions:

  • Endoscopic secondary prophylaxis is effective for eradicating esophageal varices and preventing bleeding.
  • Band ligation appears superior to sclerotherapy, offering lower rebleeding rates and requiring fewer sessions.
Abstract

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