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Frequency of gastropathy and gastric varices in children with extrahepatic portal venous obstruction treated with sclerotherapy.
J Gastroenterol Hepatol. 2004 Nov; 19(11):1253-6.JG

Abstract

BACKGROUND

There are limited reports of the effect of endoscopic sclerotherapy (EST) on portal hypertensive gastropathy (PHG) and gastric varices (GV) in children with extrahepatic portal venous obstruction (EHPVO). We have studied the prevalence of PHG and GV in children with EHPVO and assessed the effect of EST on them on long-term follow-up.

METHODS

From January 1992 to June 2002, consecutive children presenting with variceal bleeding due to EHPVO were included in this study. All children underwent EST at presentation and at 2-3 week intervals thereafter. During each session of endoscopy, gastric mucosa and fundus of the stomach was screened carefully to detect PHG and GV. Gastric varices were classified as gastroesophageal (GOV) and isolated gastric varices (IGV).

RESULTS

In total, 274 cases of EHPVO were managed during the study period. The mean age was 7.4 +/- 3.5 years with a male to female ratio of 2.3:1. Of these 274 cases, 186 completed the EST program (study population), 60 were lost to follow-up, five died and 23 underwent surgery. At presentation (n = 274) 27% cases had PHG (3.6% severe) and 68.6% had GV (GOV 66.8%, IGV 1.8%). Following EST (n = 186) there was a significant (P < 0.001) decrease in GOV (45% from 64%) but an increase in IGV (14% from 1%) and PHG (51.6% from 24.7%). There was also a significant increase in severe PHG (15.6% from 3.2%, P < 0.05). On follow-up (mean follow-up 38 +/- 30 months) 19% children with IGV bled while none with PHG bled.

CONCLUSIONS

Portal hypertensive gastropathy and gastric varices are quite common in children with EHPVO. Following EST, there is a chance of developing isolated gastric varices.

Authors+Show Affiliations

Division of Pediatric Gastroenterology, Department of Gastroenterology, PGIMER, Chandigarh, India. ujjal.poddar@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15482531

Citation

Poddar, Ujjal, et al. "Frequency of Gastropathy and Gastric Varices in Children With Extrahepatic Portal Venous Obstruction Treated With Sclerotherapy." Journal of Gastroenterology and Hepatology, vol. 19, no. 11, 2004, pp. 1253-6.
Poddar U, Thapa BR, Singh K. Frequency of gastropathy and gastric varices in children with extrahepatic portal venous obstruction treated with sclerotherapy. J Gastroenterol Hepatol. 2004;19(11):1253-6.
Poddar, U., Thapa, B. R., & Singh, K. (2004). Frequency of gastropathy and gastric varices in children with extrahepatic portal venous obstruction treated with sclerotherapy. Journal of Gastroenterology and Hepatology, 19(11), 1253-6.
Poddar U, Thapa BR, Singh K. Frequency of Gastropathy and Gastric Varices in Children With Extrahepatic Portal Venous Obstruction Treated With Sclerotherapy. J Gastroenterol Hepatol. 2004;19(11):1253-6. PubMed PMID: 15482531.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frequency of gastropathy and gastric varices in children with extrahepatic portal venous obstruction treated with sclerotherapy. AU - Poddar,Ujjal, AU - Thapa,Babu Ram, AU - Singh,Kartar, PY - 2004/10/16/pubmed PY - 2005/3/23/medline PY - 2004/10/16/entrez SP - 1253 EP - 6 JF - Journal of gastroenterology and hepatology JO - J Gastroenterol Hepatol VL - 19 IS - 11 N2 - BACKGROUND: There are limited reports of the effect of endoscopic sclerotherapy (EST) on portal hypertensive gastropathy (PHG) and gastric varices (GV) in children with extrahepatic portal venous obstruction (EHPVO). We have studied the prevalence of PHG and GV in children with EHPVO and assessed the effect of EST on them on long-term follow-up. METHODS: From January 1992 to June 2002, consecutive children presenting with variceal bleeding due to EHPVO were included in this study. All children underwent EST at presentation and at 2-3 week intervals thereafter. During each session of endoscopy, gastric mucosa and fundus of the stomach was screened carefully to detect PHG and GV. Gastric varices were classified as gastroesophageal (GOV) and isolated gastric varices (IGV). RESULTS: In total, 274 cases of EHPVO were managed during the study period. The mean age was 7.4 +/- 3.5 years with a male to female ratio of 2.3:1. Of these 274 cases, 186 completed the EST program (study population), 60 were lost to follow-up, five died and 23 underwent surgery. At presentation (n = 274) 27% cases had PHG (3.6% severe) and 68.6% had GV (GOV 66.8%, IGV 1.8%). Following EST (n = 186) there was a significant (P < 0.001) decrease in GOV (45% from 64%) but an increase in IGV (14% from 1%) and PHG (51.6% from 24.7%). There was also a significant increase in severe PHG (15.6% from 3.2%, P < 0.05). On follow-up (mean follow-up 38 +/- 30 months) 19% children with IGV bled while none with PHG bled. CONCLUSIONS: Portal hypertensive gastropathy and gastric varices are quite common in children with EHPVO. Following EST, there is a chance of developing isolated gastric varices. SN - 0815-9319 UR - https://www.unboundmedicine.com/medline/citation/15482531/Frequency_of_gastropathy_and_gastric_varices_in_children_with_extrahepatic_portal_venous_obstruction_treated_with_sclerotherapy_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0815-9319&amp;date=2004&amp;volume=19&amp;issue=11&amp;spage=1253 DB - PRIME DP - Unbound Medicine ER -