SCLEROTHERAPY OF BLEEDING ESOPHAGEAL-VARICES IN CHILDREN WITH PREHEPATIC PORTAL-HYPERTENSION - A PROSPECTIVE EVALUATION OVER 7 YEARS

Objective: To assess the effect of sclerotherapy in arresting bleeding from oesophageal varices, on the incidence of recurrent bleeding and on mortality in children with prehepatic portal hypertension. Patients : Fourteen children with prehepatic portal hypertension were followed up. The control group comprized 20 children also with prehepatic porta l hypertension treated over a period of 7 years. Methods: Endoscopic s clerotherapy was performed using a combined para- and intravariceal te chnique. Results: Acute bleeding from oesophageal varices was arrested in all patients in the sclerotherapy group. None of the patients in t he sclerotherapy group died, while 40% of those in the control group d ied. The incidence of rebleeding in the sclerotherapy group was reduce d by 53% compared with the control group. The spontaneous development of a splenorenal shunt was also demonstrated by control splenoportogra phy in some children. Conclusion: On the basis of our results, injecti on sclerotherapy should be the treatment of choice for bleeding oesoph ageal varices in children with prehepatic portal hypertension.