Frequency of gastropathy and gastric varices in children with extrahepatic portal venous obstruction treated with sclerotherapy

Authors: PODDAR, UJJAL; THAPA, BABU RAM; SINGH, KARTAR

Source: Journal of Gastroenterology and Hepatology, Volume 19, Number 11, November 2004 , pp. 1253-1256(4)

Buy & download fulltext article:

Price: $48.00 plus tax (Refund Policy)

Abstract:

Background:

There are limited reports of the effect of endoscopic sclerotherapy (EST) on portal hypertensive gastropathy (PHG) and gastric varices (GV) in children with extrahepatic portal venous obstruction (EHPVO). We have studied the prevalence of PHG and GV in children with EHPVO and assessed the effect of EST on them on long-term follow-up. Methods:

From January 1992 to June 2002, consecutive children presenting with variceal bleeding due to EHPVO were included in this study. All children underwent EST at presentation and at 2-3 week intervals thereafter. During each session of endoscopy, gastric mucosa and fundus of the stomach was screened carefully to detect PHG and GV. Gastric varices were classified as gastroesophageal (GOV) and isolated gastric varices (IGV). Results:

In total, 274 cases of EHPVO were managed during the study period. The mean age was 7.4 ± 3.5 years with a male to female ratio of 2.3:1. Of these 274 cases, 186 completed the EST program (study population), 60 were lost to follow-up, five died and 23 underwent surgery. At presentation (n = 274) 27% cases had PHG (3.6% severe) and 68.6% had GV (GOV 66.8%, IGV 1.8%). Following EST (n = 186) there was a significant (P < 0.001) decrease in GOV (45% from 64%) but an increase in IGV (14% from 1%) and PHG (51.6% from 24.7%).There was also a significant increase in severe PHG (15.6% from 3.2%, P < 0.05). On follow-up (mean follow-up 38 ± 30 months) 19% children with IGV bled while none with PHG bled. Conclusions:

Portal hypertensive gastropathy and gastric varices are quite common in children with EHPVO. Following EST, there is a chance of developing isolated gastric varices.

Keywords: gastric varices; gastropathy; portal hypertension; sclerotherapy

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1440-1746.2004.03470.x

Affiliations: 1: Division of Pediatric Gastroenterology, Department of Gastroenterology, PGIMER, Chandigarh, India

Publication date: 2004-11-01

Frequency of gastropathy and gastric varices in children with extrahepatic portal venous obstruction treated with sclerotherapy

Buy & download fulltext article:

Tools

Key

Text size:

Useful pages