Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation

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dc.contributor.authorBandika, Victor Lewa
dc.contributor.authorGoddard, Elizabeth A
dc.contributor.authorDe Lacey, Ronalda D
dc.contributor.authorBrown, Robin Alexander
dc.date.accessioned2021-10-08T07:17:59Z
dc.date.available2021-10-08T07:17:59Z
dc.date.issued2012
dc.description.abstractBACKGROUND: The outcome of sclerotherapy for bleeding oesophageal varices may be influenced by injection technique. In a previous study at our institution, sclerotherapy was associated with a high re-bleeding rate and oesophageal ulceration. Embolisation of the injection tract was introduced in an attempt to reduce injection-related complications. METHODS: To determine the outcome and effectiveness of injection tract embolisation in reducing injection-related complications, we retrospectively reviewed a series of 59 children who underwent injection sclerotherapy for oesophageal varices (29 for extrahepatic portal vein obstruction (EHPVO) and 30 for intrahepatic disease) in our centre. RESULTS: Sclerotherapy resulted in variceal eradication in only 11.8% of the children (mean follow-up duration: 38.4 months). Variceal eradication with sclerotherapy alone was achieved in 20.7% and 3.3% of EHPVO and intrahepatic disease patients, respectively. Injection tract embolisation was successful in reducing the number of complications and re-bleeding rates. Complications that arose included: transient pyrexia (16.7%); deep oesophageal ulcers (6.7%); stricture formation (3.3%); and re-bleeding before variceal sclerosis (23%). CONCLUSION: Injection sclerotherapy did not eradicate oesophageal varices in most children. Injection tract embolisation by sclerosant was associated with fewer complications and reduced re-bleeding rates.
dc.identifier.apacitationBandika, V. L., Goddard, E. A., De Lacey, R. D., & Brown, R. A. (2012). Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation. <i>South African Medical Journal</i>, 102(11), 884 - 177. http://hdl.handle.net/11427/34877en_ZA
dc.identifier.chicagocitationBandika, Victor Lewa, Elizabeth A Goddard, Ronalda D De Lacey, and Robin Alexander Brown "Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation." <i>South African Medical Journal</i> 102, 11. (2012): 884 - 177. http://hdl.handle.net/11427/34877en_ZA
dc.identifier.citationBandika, V.L., Goddard, E.A., De Lacey, R.D. & Brown, R.A. 2012. Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation. <i>South African Medical Journal.</i> 102(11):884 - 177. http://hdl.handle.net/11427/34877en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Bandika, Victor Lewa AU - Goddard, Elizabeth A AU - De Lacey, Ronalda D AU - Brown, Robin Alexander AB - BACKGROUND: The outcome of sclerotherapy for bleeding oesophageal varices may be influenced by injection technique. In a previous study at our institution, sclerotherapy was associated with a high re-bleeding rate and oesophageal ulceration. Embolisation of the injection tract was introduced in an attempt to reduce injection-related complications. METHODS: To determine the outcome and effectiveness of injection tract embolisation in reducing injection-related complications, we retrospectively reviewed a series of 59 children who underwent injection sclerotherapy for oesophageal varices (29 for extrahepatic portal vein obstruction (EHPVO) and 30 for intrahepatic disease) in our centre. RESULTS: Sclerotherapy resulted in variceal eradication in only 11.8% of the children (mean follow-up duration: 38.4 months). Variceal eradication with sclerotherapy alone was achieved in 20.7% and 3.3% of EHPVO and intrahepatic disease patients, respectively. Injection tract embolisation was successful in reducing the number of complications and re-bleeding rates. Complications that arose included: transient pyrexia (16.7%); deep oesophageal ulcers (6.7%); stricture formation (3.3%); and re-bleeding before variceal sclerosis (23%). CONCLUSION: Injection sclerotherapy did not eradicate oesophageal varices in most children. Injection tract embolisation by sclerosant was associated with fewer complications and reduced re-bleeding rates. DA - 2012 DB - OpenUCT DP - University of Cape Town IS - 11 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2012 SM - 0038-2469 T1 - Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation TI - Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation UR - http://hdl.handle.net/11427/34877 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34877
dc.identifier.vancouvercitationBandika VL, Goddard EA, De Lacey RD, Brown RA. Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation. South African Medical Journal. 2012;102(11):884 - 177. http://hdl.handle.net/11427/34877.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Child and Adolescent Psychiatry
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue11
dc.source.journalvolume102
dc.source.pagination884 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.6263
dc.subject.otherChild
dc.subject.otherChild, Preschool
dc.subject.otherEmbolization, Therapeutic
dc.subject.otherEndoscopy
dc.subject.otherEsophageal and Gastric Varices
dc.subject.otherFemale
dc.subject.otherGastrointestinal Agents
dc.subject.otherGastrointestinal Hemorrhage
dc.subject.otherHumans
dc.subject.otherInfant
dc.subject.otherMale
dc.subject.otherOctreotide
dc.subject.otherOleic Acids
dc.subject.otherSclerosing Solutions
dc.subject.otherSclerotherapy
dc.subject.otherGastrointestinal Agents
dc.titleEndoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous obstruction: benefit of injection tract embolisation
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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