Endoscopic sclerotherapy for varices in children

Sarin, S. K. ; Misra, S. P. ; Singal, A. K. ; Thorat, V. ; Broor, S. L. (1988) Endoscopic sclerotherapy for varices in children Journal of Pediatric Gastroenterology and Nutrition, 7 (5). pp. 662-666. ISSN 0277-2116

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Thirty-one children with variceal bleeding due to portal hypertension (extrahepatic obstruction 19, non-cirrhotic portal fibrosis five, and cirrhosis of liver seven patients) were treated with endoscopic sclerotherapy with absolute alcohol. Acute variceal bleeding was successfully controlled in 10 patients by emergency sclerotherapy. A 3 weekly schedule of sclerotherapy could achieve obliteration of varices in all the patients. The mean (SD) number of sclerotherapy courses and the time required for variceal cradication was 4.5 × 1.7 and 14.4 × 3.9 weeks, respectively. During a mean follow-up of 23.3 × 11.4 months, variceal recurrence was seen in three (9.7%) patients, two with cirrhosis and one with noncirrhotic portal fibrosis. Recurrence was not seen in any patient with extrahepatic obstruction. Five (16.1%) patients had a rebleed that could be controlled with emergency selerotherapy. Esophageal stricture developed in four (12.9%) patients and could be dilated easily in all of them. The other complications of sclerotherapy included retrosternal pain, dysphagia, and fever; these were mild and short lasting. Survival in patients with extrahepatic obstruction and noncirrhotic portal fibrosis was 100%. The only death was in a cirrhotic, who died due to terminal hepatic failure. In conclusion, endoscopic sclerotherapy can be recommended as a safe and effective treatment in children for the control of acute variceal bleeding and for variceal obliteration.

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