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Upper gastro-intestinal tract bleeding in cirrhotic children candidates for liver transplantation.

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Sokal, Etienne [UCL] Van Hoorebeeck, N Van Obbergh, Luc [UCL] Otte, Jean-Bernard [UCL] Buts, Jean-Paul [UCL]

Signs of portal hypertension, history of upper gastro-intestinal tract bleeding episodes and outcome of the latter were recorded in 76 cirrhotic children evaluated for liver transplantation. Fifty-three (70%) had varices and 22 (29%) had experienced upper gastro-intestinal tract bleeding. Of these 22, 19 bled from varices and 3 from ulcers. Non bleeding ulcers were also found in five patients bleeding from varices. Iterative sclerotherapy controlled acute variceal bleeding in all but one patient in whom emergency transplantation was performed. Six of the eight patients with ulcers were successfully treated by the H2 histamine receptor antagonist ranitidine. We conclude that iterative sclerotherapy is efficient to control acute variceal bleeding and prevents recurrent bleeding in children with end-stage liver diseases awaiting liver replacement. Bleeding asymptomatic ulcers are frequent and respond to H2 histamine receptor antagonists.

Document type Article de périodique (Journal article) – Journal Article
Publication date 1992
Journal information "European journal of pediatrics" - Vol. 151, no. 5, p. 326-8 (1992)
Peer reviewed yes
issn 0340-6199
Publication status Publié
Affiliation UCL - MD/CHIR - Département de chirurgie
MESH Subject Acute Disease ; Adolescent ; Child ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices - complications ; Gastrointestinal Hemorrhage - diagnosis - etiology - therapy ; Humans ; Liver Cirrhosis - complications - surgery ; Liver Transplantation ; Sclerotherapy
Links
  1. Bass N (1987) Preventing haemorrhage from oesophageal varices. N Engl J Med 317:893–895
  2. Cabriada J, Orive V, Alzgate L, Arenas J (1988) Efficacy of emergency endoscopic sclerotherapy in acute haemorrhage of oesophageal varices. Rev Esp Enferm Apar Dig 74:129–133
  3. Chung RS, Dearlove J (1988) The source of recurrent haemorrhage during long-term sclerotherapy. Surgery 104:687–696
  4. Dessanti A, Falchetti D, Alberti D, Rigamonti W, Caccia G (1988) Endoluminar sclerotherapy of oesophageal varices: Technique and preliminary results. Z Kinderchir 43 [Suppl] I: 47–49
  5. Eurotransplant Newsletter (1989) No 61
  6. Howard E, Stringer M, Mowat AP (1988) Assessment of injection sclerotherapy in the management of 152 children with oesophageal varices. Br J Surg 75:404–408
  7. North Italian Club for the Study and Treatment of Oesophageal Varices (1988) Prediction of the first variceal haemorrhage in patients with cirrhosis of the liver and oesophageal varices. N Engl J Med 319:983–989
  8. Otte JB, Ville de Goyet J de, Alberti D, et al (1989) Liver transplantation in children: University of Louvain experience with the first 139 patients. Clinical transplant, Terasaki Ed, UCLA tissue Typing Laboratory, Los Angeles California
  9. Otte JB, Ville de Goyet J de, Sokal E, et al (1990) Size reduction of the donor liver is a safe way to alleviate the shortage of size-matched organs in paediatric liver transplantation. Ann Surg 211:146–157
  10. Pugh RNH, Murray Lyon IM, Dawson JL (1973) Transections of the oesophagus for bleeding varices. Br J Surg 60:646–649
  11. Sauerbruch T, Wotzka R, Kopcke W, et al (1988) Prophylactic sclerotherapy before the first episode of variceal haemorrhage in patients with cirrhosis. N Engl J Med 319:8–15
  12. Sokal EM, Veyckemans F, Ville de Goyet J de, et al (1990) Liver transplantation in children less than one year of age. J Pediatr 117:205–210
  13. Stringer M, Howard E, Mowat AP (1989) Endoscopic sclerotherapy in the management of oesophageal varices in 61 children with biliary atresia. J Pediatr Surg 24:438–442
  14. Terblanche J, Burroughs K, Hobbs K (1989) Controversies in the management of bleeding oesophageal varices. First of two parts. N Engl J Med 320:1393–1398
  15. Teres J, Planas R, Panes J, et al (1990) Vasopressin/Nitroglycerin infusion vs oesophageal tamponade in the treatment of acute variceal bleeding: a randomized controlled trial. Hepatology 11:964–968
  16. Van Hottegem P, Van Besien K, Broeckaert L, Rutgeerts P, Fevery J (1988) Endoscopic sclerotherapy of oesophageal varices: long term follow up, recurrence and survival. J Clin Gastroenterol 10:368–372
Bibliographic reference Sokal, Etienne ; Van Hoorebeeck, N ; Van Obbergh, Luc ; Otte, Jean-Bernard ; Buts, Jean-Paul. Upper gastro-intestinal tract bleeding in cirrhotic children candidates for liver transplantation.. In: European journal of pediatrics, Vol. 151, no. 5, p. 326-8 (1992)
Permanent URL http://hdl.handle.net/2078.1/9612