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Endoscopic sclerotherapy for varices in children
S K Sarin1, S P Misra, A K Singal
1Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India.
Journal of Pediatric Gastroenterology and Nutrition
|September 1, 1988
Summary
Endoscopic sclerotherapy effectively controls acute variceal bleeding in children. This safe treatment obliterates esophageal varices, with low recurrence rates and manageable complications, offering a promising therapeutic option.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Endoscopic Interventions
Background:
- Portal hypertension in children can lead to life-threatening variceal bleeding.
- Esophageal varices are a common complication requiring effective management strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of endoscopic sclerotherapy using absolute alcohol in pediatric patients with variceal bleeding.
- To assess the long-term outcomes, including variceal obliteration, recurrence, and complications.
Main Methods:
- Thirty-one children with variceal bleeding underwent endoscopic sclerotherapy with absolute alcohol.
- Treatment involved emergency sclerotherapy for acute bleeding and a scheduled regimen for variceal obliteration.
- Follow-up assessments monitored for recurrence and complications.
Main Results:
- Acute bleeding was controlled in 10 patients via emergency sclerotherapy.
- All patients achieved variceal obliteration within a mean of 14.4 weeks.
- Variceal recurrence occurred in 9.7% of patients, primarily those with cirrhosis.
- Esophageal strictures developed in 12.9% but were easily managed.
Conclusions:
- Endoscopic sclerotherapy with absolute alcohol is a safe and effective treatment for pediatric variceal bleeding and variceal obliteration.
- The procedure demonstrates a favorable safety profile with manageable complications.
- High survival rates were observed, particularly in patients with extrahepatic obstruction and non-cirrhotic portal fibrosis.