[The endoscopic sclerotherapy of esophageal varices in children]

G Aprodu1, D Goţia, S Gavrilescu

  • 1Spitalul Clinic de Copil Sfânta Maria, Clinica de Chirurgie Pediatrică, Iaşi.

Insights

Injection sclerotherapy effectively treats esophageal varices in children, particularly for chronic conditions. This method helps manage bleeding and delays necessary surgeries until the child is older.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery

Context:

  • Esophageal varices pose a significant bleeding risk in children.
  • Acute bleeding from esophageal varices requires prompt intervention.

Purpose:

  • To evaluate the long-term efficacy and safety of injection sclerotherapy for pediatric esophageal varices.
  • To establish injection sclerotherapy as a standard treatment for managing esophageal varices in children.

Summary:

  • Injection sclerotherapy involves injecting a sclerosing agent into and around dilated esophageal veins.
  • The procedure is performed in both emergency and chronic settings for bleeding varices.
  • Authors report extensive experience with this method since 1992 at Children's Hospital of Iaşi.

Impact:

  • Injection sclerotherapy provides a valuable, less invasive treatment option for pediatric esophageal varices.
  • This technique allows for the postponement of more invasive decompressive procedures, enabling treatment at an optimal age.

Related Concept Videos

Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Esophageal Varices-I: Introduction01:24

Esophageal Varices-I: Introduction

Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

Varicose Veins II: Diagnostic Studies and Interprofessional Care

Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...