Endoscopic sclerotherapy of esophageal varicose vein in children with portal hypertension

Objective Hemorrhage from esophageal varicose vein caused by portal hypertension is an uncommon but serious complication in children. The mortality rate is very high and it lacks of effective method in its treatment. However, it was shown that the endoscopic sclerotherapy was effective in the treatment of hemorrhage from esophageal varices. The aim of this study was to investigate the efficacy of sclerotherapy of esophageal varices in children with portal hypertension.Methods Ten children with portal hypertension and hemorrhage from esophageal varicose (5 cases of extra hepatic portal hypertension, 4 cases of cirrhosis and 1 case of schistosome infection) presenting with hematemesis and /or melena were subjected to esophageal varices sclerotherapy using 1% aethoxysklerol as sclerosant from 1996 to Jun. 2000. The mean age of the patients was 8 2 years. Nine patients were male and 1 patient was female. Nine children had splenectomy previously.Results Ten patients experienced a total of 22 injections, while 8 children had two and 2 had three injections. Nine cases received general anesthesia but 1 received larephageal anesthesia. Rebleeding after therapy happened only in 1 case. Follow up examination revealed that variceal grade decreased significantly after the first injection. Eradication of varices was completely achieved in 4 children and basic eradication was achieved in 5 children. Conclusion The results suggested that endoscopic sclerotherapy of esophageal varicose vein in children was a safe and effective procedure. Long term and regular endoscopic follow up and repeated sclerotherapy were needed to prevent from relapse.