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Bleeding oesophageal varices with long term follow up
Archives of Disease in Childhood
|April 1, 1984
Summary
This study followed 27 children with esophageal varices bleeding. Injection sclerotherapy effectively controlled bleeding in 97% of cases, recommending a conservative treatment approach for pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Vascular Surgery
Background:
- Esophageal varices are a serious complication in children, often presenting with hematemesis or melena.
- Portal vein thrombosis is a common cause of esophageal varices in pediatric patients.
- Splenomegaly is a consistent finding in children with bleeding varices.
Purpose of the Study:
- To evaluate the long-term outcomes of children with bleeding esophageal varices.
- To assess the efficacy of injection sclerotherapy in managing pediatric esophageal variceal bleeding.
- To determine optimal management strategies for this condition in children.
Main Methods:
- Long-term follow-up of 27 children with a history of esophageal varices bleeding.
- Analysis of bleeding episodes, treatment interventions, and outcomes.
- Review of precipitating factors and complications, including shunt thrombosis.
Main Results:
- Injection sclerotherapy was used in 68 of 182 bleeding admissions, achieving a 97% control rate.
- Portal vein thrombosis was present in 20 children, with a mean age of presentation of 5.2 years.
- Shunts performed in children under 10 years old were associated with a high thrombosis rate.
Conclusions:
- A conservative management approach including transfusion, pitressin, and injection sclerotherapy is recommended for pediatric esophageal variceal bleeding.
- Injection sclerotherapy is a highly effective treatment for controlling acute bleeding.
- Esophageal transection may be considered for refractory cases unresponsive to sclerotherapy.