PERCUTANEOUS TRANSJUGULAR INTRAHEPATIC STENT-SHUNT FOR TREATMENT OF INTRACTABLE VARICOSE BLEEDING IN PEDIATRIC-PATIENTS

Two 1O-year and 11-year-old children with oesophageal and gastric vari cose haemorrhage unresponsive to medical treatment and repeated endosc opic sclerotherapy underwent percutaneous transjugular intrahepatic po rtosystemic shunting (TIPSS). A newly developed introducing system was used. The procedure was performed to avoid the increased risk of emer gency liver transplantation in children with hepatic failure. Immediat ely after the procedure bleeding stopped and the patient's condition i mproved. Ascites disappeared and liver function improved. The stent sh unt was shown to be patent by angiography and Doppler ultrasound for a follow up period of more than 1 year. TIPSS may be of benefit in chil dren with severe portal hypertension. It allows control of intractable bleeding, and stabilizes the patients preparing them for subsequent e lective orthotopic liver transplantation.