title: Risk of gastrointestinal bleeding during adolescence and early adulthood in children with portal vein obstruction.
abstract: OBJECTIVE
  To estimate the risk of bleeding during adolescence and early adulthood in a group of children with portal vein obstruction who had not undergone an effective treatment beforehand.
  
  
  METHODS
  Children (n = 44) were followed up from age 12 years to a mean age of 20 years (range, 15-34 years). Actuarial risk of bleeding, related to previous occurrence of gastrointestinal bleeding and to pattern of varices at age 12, was calculated yearly.
  
  
  RESULTS
  Twenty-four children presented with gastrointestinal bleeding after age 12, and 20 did not bleed. The overall actuarial probability of bleeding was 49% at age 16 and 76% at age 24. Probability of bleeding at age 23 was higher in children who had bled before age 12 than in children who had not bled (93% vs 56%; P =.007). Probabilities of bleeding at age 18 and at age 23 were 60% and 85%, respectively, in patients who had grade II or III esophageal varices at age 12. The 9 children without varices or with grade I varices only on endoscopy did not bleed between the ages of 12 and 20 years.
  
  
  CONCLUSIONS
  Children with portal vein obstruction have a >50% risk of bleeding during adolescence; the pattern of varices on endoscopy at age 12 may have a prognostic value.
authors.affiliation: Service d'Hépatologie Pédiatrique, Service de Chirurgie, and Service de Radiologie, Département de Pédiatrie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: P
authors.initials: P
authors.lastname: Lykavieris
authors.forename: F
authors.initials: F
authors.lastname: Gauthier
authors.forename: P
authors.initials: P
authors.lastname: Hadchouel
authors.forename: M
authors.initials: M
authors.lastname: Duche
authors.forename: O
authors.initials: O
authors.lastname: Bernard
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D004932:Esophageal and Gastric Varices / Q000150:complications*; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D011169:Portal Vein; D012307:Risk Factors; D014652:Vascular Diseases / Q000150:complications