Paediatric Hepatobiliary
Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: Benefit of injection tract embolisation
Abstract
Methods. To determine the outcome and effectiveness of injection tract embolisation in reducing injection-related complications, we retrospectively reviewed a series of 59 children who underwent injection sclerotherapy for oesophageal varices (29 for extrahepatic portal vein obstruction (EHPVO) and 30 for intrahepatic disease) in our centre.
Results. Sclerotherapy resulted in variceal eradication in only 11.8% of the children (mean follow-up duration: 38.4 months). Variceal eradication with sclerotherapy alone was achieved in 20.7% and 3.3% of EHPVO and intrahepatic disease patients, respectively. Injection tract embolisation was successful in reducing the number of complications and re-bleeding rates. Complications that arose included: transient pyrexia (16.7%); deep oesophageal ulcers (6.7%); stricture formation (3.3%); and re-bleeding before variceal sclerosis (23%).
Conclusion. Injection sclerotherapy did not eradicate oesophageal varices in most children. Injection tract embolisation by sclerosant was associated with fewer complications and reduced re-bleeding rates.
Authors' affiliations
Victor Lewa Bandika, School of Child and Adolescent Health, Red Cross War Memorial Children’s Hospital and University of Cape Town, Cape Town
Elizabeth A Goddard, School of Child and Adolescent Health, Red Cross War Memorial Children’s Hospital and University of Cape Town, Cape Town
Ronalda D De Lacey, School of Child and Adolescent Health, Red Cross War Memorial Children’s Hospital and University of Cape Town, Cape Town
Robin Alexander Brown, School of Child and Adolescent Health, Red Cross War Memorial Children’s Hospital and University of Cape Town, Cape Town
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Article History
Date published: 2012-09-11
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