Injection Sclerotherapy of Bleeding Oesophageal and Gastric Varices in Children

Abstract

During a 4-year period (1980–1984) nine children aged 11 to 13 years with acute or recent bleeding from gastro-oesophageal varices were treated by injection sclero-therapy. Chronic liver disease was the cause of portal hypertension in three and extrahepatic portal venous obstruction in six. Seven had experienced recurrent bleeding episodes, and massive haemorrhage initiated treatment in two children. Seven patients, rebled before eradication of all critical varices and two after, both from ulcers at the site of injection. All critical varices were eradicated in the nine children within a median of 1 1/2 months, after a median of five courses of injections. No further variceal bleeding occurred during the follow-up period of up to 57 months (mean. 20.9 months). Complications included oesophageal and gastric ulcers in four patients. One patient with congenital hepatic fibrosis and aortic insufficiency died of septicaemia 19 months after entering the treatment.

Key Words:

• Children
• cirrhosis
• portal vein thrombosis
• sclerotherapy
• varices