All issues > Volume 43(9); 2000

Original Article

J Korean Pediatr Soc. 2000;43(9):1241-1247. Published online September 15, 2000.

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

Jeong Hee JH Moon¹, Mi Hyon MH Tae¹, Nam Seon NS Beck¹

¹Department of Pediatric, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea

Abstract

Purpose
: Endoscopic variceal sclerotherapy(EVS) has been considered the mainstay therapy for bleeding esophageal varices in adults. Howevere, 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 6years of age(mear age, 2.5 year) with esophageal varices. Outcome was assessed with respect to syrvival, 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 thrombosis, 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¡¾0.7 sessions of EVL(ranging from two to four). The numbers of bands per person were 5.6¡¾1.8, and the numbers of bands per session were 2.2¡¾1.0. 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 effestive in controlling variceal hemorrhage in children with portal hypertension, regardless of etiology. The complication rate is low and EVL is an acceptable and perhaps preferable alternative to EVS in children with esophageal varices. But regular periodic examination for recurrence of varices after eradication should be required.

Keywords :Esophageal variceal, Endoscopic variceal ligation