Ten years experience with paravariceal injection sclerotherapy of esophageal varices in children

Abstract

Esophageal varices in 59 consecutive children with portal hypertension were treated by paravariceal injection sclerotherapy. Repeated injections were performed using a special rigid instrument under general anesthesia. In children older than 10 a flexible endoscope was used without general anesthesia. Using 0.5% Polidocanol, a fibrous layer protecting varices against the further bleeding was produced in 59 children. Complications during treatment included hemorrhage, esophageal ulceration and stricture, each in two children. 55 children have been followed for 6 months to 10 years after two phases of paravariceal injection following the first phase of treatment. Three rebleeds have occurred in this group. Sclerotherapy was repeated. Thereafter, using a regular endoscopic control every year, no rebleeding occurred. Four children with liver cirrhosis died of liver failure. All other children except four foreign ones could be followed. 51 of them (86%) are alive.