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[Therapy of bleeding esophageal varices in children--present and future aspects]
Insights
Endoscopic sclerotization has been a routine treatment for pediatric portal hypertension and esophageal varices since 1990. This study evaluates recent outcomes and recommends optimal management strategies for children.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Interventional Endoscopy
Context:
- Portal hypertension in children presents significant challenges, primarily due to hemorrhage from esophageal varices.
- Traditional surgical and conservative methods have been employed for decades.
- The introduction of endoscopic sclerotherapy in 1990 marked a significant advancement in managing this condition.
Purpose:
- To evaluate the clinical experience with endoscopic sclerotherapy for pediatric portal hypertension over the past three years.
- To assess the efficacy and safety of sclerotherapy in conjunction with medicamentous and surgical treatments.
- To recommend optimal therapeutic procedures for children with esophageal varices.
Summary:
- Since 1990, endoscopic sclerotherapy has been a routine method for treating 14 pediatric patients (ages 5-17) with portal hypertension and esophageal varices.
- The department's experience over the last three years, combining sclerotherapy with other treatments, is analyzed.
- The study aims to establish best practices and anticipate future therapeutic developments.
Impact:
- Provides valuable insights into the long-term management of pediatric portal hypertension.
- Contributes to the evidence base for endoscopic sclerotherapy in a pediatric population.
- Informs clinical decision-making for optimizing treatment strategies and improving patient outcomes.
Abstract:
The authors' department has devoted the past 25 years to treatment of portal hypertension in children and above all to the most dramatic manifestations-haemorrhage from oesophageal varicosities. In previous years a number of surgical and conservative methods was used. The milestone in therapeutic strategy and tactics was the year 1990 when endoscopic sclerotization of oesophageal varices was introduced as a routine method. Since then 14 patients aged 5-17 years were treated. In addition to sclerotization also medicamentous and surgical treatment are used. The authors evaluate their experience assembled during the past three years and recommend optimal procedures in children. They try also to foresee the future development of therapy.