Endoscopic Sclerotherapy on Variceal Bleeding in Children

Abstract

Background: Since variceal bleeding due to portal hypertension is associated with a high mortality rate, effective treatment leads to improved survival. Endoscopic sclerotherapy is an effective treatment for bleeding esophageal varices, but it is associated with significant complications. To determine the efficacy and safety of endoscopic sclerotherapy, we evaluated the patients with variceal bleeding who underwent sclerotherapy in our center.

Materials and Methods: This study was a case-series study in which, we evaluated 79 patients who referred for esophageal variceal bleeding and underwent sclerotherapy and completed the questionnaire.

Results: From79 patients, 52 (65.8%) weremale, and 27 (34.2%) were female. The rate of success (arrest of acute bleeding by endoscopic sclerotherapy) was 100%, but it was 55.7%for long-termsclerotherapy; 53.3%of patients with liver disease, and 64.7%of patients with extraheaptic portal hypertension had suitable response; 58.3%of patients with ChildA, 83.3%of those with Child B and 14.3%of Child C cirrhotic patients demonstrated appropriate response. In fundal varices, 15.2% were improved, 21.5% were accelerated and 43.3% showed no significant changes. During treatment, 31.6%had one of the complications of sclerotherapy. The rates of rebleeding and mortality were 54.4% and 8.9%, respectively.

Conclusion:Although sclerotherapy reduced themortality attributable to acute variceal bleeding, but the long-term effectiveness of sclerotherapy was not very high.