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Underwater Endoscopic Injection Sclerotherapy for Gastroesophageal Varices
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Acute Variceal Bleeding Causes Significant Morbidity.

Marta Carneiro de Moura1, Shiyi Chen2, Binita M Kamath1

  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics.

Journal of Pediatric Gastroenterology and Nutrition
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PubMed
Summary
This summary is machine-generated.

Children experiencing acute variceal bleeding (AVB) face significant morbidity, including ascites and infections, though the risk of death is low. Morbidity impacts length of stay and should inform prophylaxis decisions for first-time AVB in pediatric patients.

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Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Clinical Research

Background:

  • The necessity of primary prophylaxis for variceal bleeding in children remains uncertain due to limited evidence on treatment efficacy and the impact of initial bleeding events.
  • Previous research has estimated mortality rates, but a comprehensive understanding of morbidity associated with acute variceal bleeding (AVB) in pediatric populations is lacking.

Purpose of the Study:

  • To investigate the morbidity associated with acute variceal bleeding (AVB) in children.
  • To identify factors contributing to morbidity following AVB in pediatric patients.

Main Methods:

  • A retrospective review was conducted on children diagnosed with chronic liver disease or portal vein thrombosis who were admitted for acute upper gastrointestinal bleeding between 2000 and 2015.
  • Data from 70 AVB episodes in 57 children were analyzed.

Main Results:

  • Fifty-seven percent of AVB episodes resulted in post-bleeding morbidity, including ascites (34%), infections (30%), and respiratory complications (24%).
  • Morbidity was associated with higher total bilirubin levels and longer hospital stays (18 vs. 4 days).
  • The mortality rate within six weeks of the first bleed was low (4%), particularly in children without cirrhosis.

Conclusions:

  • Children with AVB experience substantial morbidity, but the risk of mortality is low.
  • Morbidity associated with AVB, especially the first episode, should be a key consideration in future research evaluating the risks and benefits of primary prophylactic therapies in children.