Assessment of injection sclerotherapy in the management of 152 children with oesophageal varices
Article first published online: 8 DEC 2005
Copyright © 1988 British Journal of Surgery Society Ltd.
British Journal of Surgery
Volume 75, Issue 5, pages 404–408, May 1988
How to Cite
Howard, E. R., Stringer, M. D. and Mowat, A. P. (1988), Assessment of injection sclerotherapy in the management of 152 children with oesophageal varices. Br J Surg, 75: 404–408. doi: 10.1002/bjs.1800750504
- Issue published online: 8 DEC 2005
- Article first published online: 8 DEC 2005
- Manuscript Accepted: 12 FEB 1988
- Portal hypertension;
- oesophageal varices;
- endoscopic sclerotherapy
A total of 152 consecutive children with oesophageal varices have been endoscopically reviewed since 1979. In all, 108 of these children presented with variceal bleeding which was managed by injection sclerotherapy. Variceal obliteration was achieved in 33 (92 per cent) children with extrahepatic portal hypertension and 54 (75 per cent) with intrahepatic portal hypertension. Prophylactic injection sclerotherapy was used to obliterate large varices in 11 children with no history of haemorrhage. Bleeding episodes occurred in 38 (39 per cent) children before variceal obliteration was complete. However, the mortality rate from variceal bleeding was only 1 per cent. Complications were oesophageal ulceration (29 per cent) and stricture (16 per cent) which both resolved with conservative management. During a mean follow-up period of 2.9 years after sclerotherapy, recurrent oesophageal or gastric varices developed in 12 (12 per cent) cases, with rebleeding in 9 (9 per cent), but all responded successfully to a second course of treatment. These results are superior to contemporary surgical management and injection sclerotherapy should therefore currently be the primary treatment of choice for bleeding oesophageal varices in children.