Esophageal endoscopic sclerotherapy in children using 3% aqueous phenol.
OBJECTIVE
To study the efficacy of endoscopic variceal sclerotherapy (EST) in controlling acute variceal bleeding and preventing recurrence of bleeding from esophageal varices in children.


METHODS
Ninety children (mean age 7.3 +/- 3.0 years) with portal hypertension [extra-hepatic portal venous obstruction (EHPVO) 83, cirrhosis 7] presenting with hematemesis and/or melena were subjected to EST using 3% phenol in water as sclerosant.


RESULTS
Active variceal bleeding could be controlled in 31 of 34 (91%) cases. Varices could be obliterated in 87% of patients with a mean of 5.4 +/- 2.5 injection sessions. Pre-obliteration variceal rebleeding was observed in 15% of patients. Complications such as esophageal ulceration, stricture and perforation were observed in 32%, 4.5% and 1% of patients respectively. Strictures responded to dilatation whereas perforation responded to conservative treatment. Recurrence of varices was seen in 22% of patients at a mean interval of 5.8 +/- 1.9 months. The mortality in the emergency group was 9.5% and nil in the elective group. Ten percent of patients required surgical intervention.


CONCLUSIONS
EST with 3% phenol in water is effective in controlling active bleeding as well as preventing recurrent bleeding from esophageal varices in children.
Supe
A N
AN
Department of Surgery, Seth G S Medical College, Bombay.
Mathur
S K
SK
Borwankar
S S
SS
D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007223:Infant; D008297:Male; D019800:Phenol; D010636:Phenols / Q000627:therapeutic use*; D012008:Recurrence; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*
D010636:Phenols; D012597:Sclerosing Solutions; D019800:Phenol