A Prospective Study of Endoscopic Esophageal Variceal Ligation Using a Multiband Ligator

McKiernan, Patrick; Beath, S. V.; Davison, Suzanne

doi:10.1097/00005176-200202000-00019

Cited by 88 publications

(81 citation statements)

References 30 publications

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“…In the study of Zargar et al (56) the mean age was 6.4 years. When the endoscopic and/or drug secondary prophylaxis are not established, or it is unsuccessful, the chance of new bleeding is higher (10,28,56) . In the present study, the mean number of UGIB episodes was the same as the one reported by Abd El-Hamid et al (1) .…”

Section: Varices Classification N (%)mentioning

confidence: 99%

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

Ferri

Ferreira

Fagundes

et al. 2012

Arq. Gastroenterol.

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-Context -Portal vein thrombosis refers to a total or partial obstruction of the blood flow in this vein due to a thrombus formation. It is an important cause of portal hypertension in the pediatric age group with high morbidity rates due to its main complication -the upper gastrointestinal bleeding. Objective -To describe a group of patients with portal vein thrombosis without associated hepatic disease of the Pediatric Hepatology Clinic of the Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil with emphasis on diagnosis, presentation form and clinical complications, and the treatment of portal hypertension. Methods -This is a descriptive study of a series of children and adolescents cases assisted from January 1990 to December 2010. The portal vein thrombosis diagnosis was established by ultrasound. Results -Of the 55 studied patients, 30 (54.5%) were male. In 29 patients (52.7%), none of the risk factors for portal vein thrombosis was observed. The predominant form of presentation was the upper gastrointestinal bleeding (52.7%). In 20 patients (36.4%), the initial manifestation was splenomegaly. During the whole following period of the study, 39 patients (70.9%) showed at least one episode of upper gastrointestinal bleeding. The mean age of patients in the first episode was 4.6 ± 3.4 years old. The endoscopic procedure carried out in the urgency or electively for search of esophageal varices showed its presence in 84.9% of the evaluated patients. The prophylactic endoscopic treatment was performed with endoscopic band ligation of varices in 31.3% of patients. Only one died due to refractory bleeding. Conclusions -The portal vein thrombosis is one of the most important causes of upper gastrointestinal bleeding in children. In all non febrile children with splenomegaly and/or hematemesis and without hepatomegaly and with normal hepatic function tests, it should be suspect of portal vein thrombosis. Thus, an appropriate diagnostic and treatment approach is desirable in an attempt to reduce morbidity and mortality.

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Section: Varices Classification N (%)mentioning

confidence: 99%

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

Ferri

Ferreira

Fagundes

et al. 2012

Arq. Gastroenterol.

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“…EST has emerged as an effective treatment for bleeding esophageal varices. 18 According to Yaccha et al EST was helpful in eradication of esophageal varies in 88% with mean session of 8 per child. 19 A study by Poddar et al, EHPVO children with EST variceal eradication was achieved in 95% of cases with mean 5.0+2.4 sessions.…”

Section: Resultsmentioning

confidence: 99%

“…20 EVL has been shown to be superior to EST because varices are eradicated rapidly with fewer sessions and it has fewer associated complications. 18,21 Zargar et al compared EST and EVL. Although EVL achieved variceal eradication more quickly, there was no difference in terms of arresting active bleeding and variceal eradication.…”

Section: Resultsmentioning

confidence: 99%

A study on demographic and clinical profile of children with extra hepatic portal venous obstruction and with special reference to thrombophilic factors

Jena

Mohanty

Patra

et al. 2017

Int J Community Med Public Health

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Background: Extra-hepatic portal vein obstruction (EHPVO) due to portal vein thrombosis is an important cause of portal hypertension in several region including India. The cause of thrombosis in these patients remains unclear. Objective of the study was to study the demographic features, etiology, clinical, laboratory findings with special reference to thrombophilic factors like protein C, protein S and antithrombin III deficiency in children with EHPVO.Methods: The prospective analysis of 62 patients of EHPVO (<14 years of age) was done in the Department of Hepatology, SCB medical College, Cuttack. After detailed history, clinical examination, Ultrasound abdomen /color Doppler and Upper GI endoscopy, the subjects were analyzed for any deficiency of thrombophilic factors like protein C, protein S and antithrombin III.Results: A total of 62 patients (37 Male, 25 Female) with mean age of 8.3+3.1 years were studied. Growth retardation was present in the form of wasting (alone) 20.9%, stunting (alone) 25.8% and both wasting and stunting was found in 9.8% cases. History of neonatal, umbilical sepsis and umbilical vein catheterization was found in 15.9% and 10.2% of cases respectively. Haemorrhage from oesophageal varices was prevalent symptoms in 85.9% patients. Splenomegaly was found in 91.9% patients and ascites in 9.4% patients. 47 patients studied for protein C, S and antithromibin III. 14 patients were found to have thrombophilia: protein C deficiency in 9, protein S deficiency in 8, Antithrombin III deficiency in 6.Conclusions: The etiology of EHPVO in the majority of patients remain still unclear. It is commonly associated impaired somatic growth. The risk of EHPVO increases in the presence of thrombophilia, resulting from deficiency of naturally occurring anticoagulant proteins like Protein C, Protein S and Antithrombin III.

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“…13,21 Kerner et al 21 found that by using multi band ligator, varices were obliterated in 2 sessions in 26 of 28 patients with minimal complications. In these studies multi band ligator was found to be technically feasible and safe in children.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Band Ligation in Esophageal Varices of Bangladeshi Children: A Tertiary Centre Experience

Mahmud

Ahmed

Gulshan

et al. 2017

Bangladesh J Child Health

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A Prospective Study of Endoscopic Esophageal Variceal Ligation Using a Multiband Ligator

Abstract: Endoscopic variceal ligation is highly effective in obliterating esophageal varices in children. The use of a multibander device for endoscopic variceal ligation is technically feasible and safe even in small children, and its use results in more rapid ablation of esophageal varices.

Cited by 88 publications

References 30 publications

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center

A study on demographic and clinical profile of children with extra hepatic portal venous obstruction and with special reference to thrombophilic factors

Outcome of Band Ligation in Esophageal Varices of Bangladeshi Children: A Tertiary Centre Experience

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