J Korean Pediatr Soc.  2000 Sep;43(9):1241-1247.

A Study of Endoscopic Variceal Ligation of under 6-Year-Old Aged Children with Esophageal Varices

• Moon JH
• Tae MH
• Beck NS

Abstract

PURPOSE: Endoscopic variceal sclerotherapy(EVS) has been considered the mainstay therapy for bleeding esophageal varices in adults. However, recent data have shown that endoscopic variceal ligation is just as efficacious and has fewer complications than EVS. Although there are many reports concerning EVL in adults, only a few studies have been done of children.
METHODS
We performed EVL in 9 children under 6 years of age(mear age, 2.5 year) with esophageal varices. Outcome was assessed with respect to survival, rebleeding, and complications.
RESULTS
The causes of portal hypertension were 3 cases of congenital hepatic fibrosis, 3 cases of biliary atresia, 2 cases of portal vein thrornbosis, and one case of portal vein fibromuscular dysplasia. The age at diagnosis ranged from 10 months to 6 years. The patients underwent a mean of 2.6+/- 0.7 sessions of EVL(ranging from two to four). The numbers of bands per person were 5.6+/-1.8, and the numbers of bands per session were 2.2+/-1.0 Two complications of esophageal rebleeding were noted, and none of the cases experienced symptoms of esophageal stenosis, nor gastroesophageal reflux.
CONCLUSION
EVL is safe and effective in controlling variceal hemorrhage in children with portal hypertension, regardless of etiology. The cornplication rate is low and EVL is an acceptable and perhaps preferable altemative to EVS in children with esophageal varices. But regular periodic examination for recurrence of varices after eradication should be required.

Keyword

Esophageal varices; Endoscopic variceal ligation

MeSH Terms

Adult
Biliary Atresia
Child*
Diagnosis
Esophageal and Gastric Varices*
Esophageal Stenosis
Fibromuscular Dysplasia
Fibrosis
Gastroesophageal Reflux
Hemorrhage
Humans
Hypertension, Portal
Ligation*
Portal Vein
Recurrence
Varicose Veins