title: Treatment of variceal bleeding.
abstract: Variceal bleeding is the most common cause of severe gastro-intestinal bleeding in childhood. Biliary atresia and portal venous obstruction are the most common causes. Each center should have a defined management protocol reflecting local practice and expertise. For patients with acute bleeding, pharmacotherapy with octreotide should be used immediately. All of these patients should undergo therapeutic endoscopy with band ligation or sclerotherapy. All children surviving variceal hemorrhage should undergo secondary prophylaxis with band ligation. No evidence supports the routine use of primary prophylaxis in children with esophageal varices.
authors.affiliation: Liver Unit, Children's Hospital NHS Trust, Birmingham, United Kingdom. Pat.Mckiernan@bhamchildrens.wmids.nhs.uk
authors.forename: P J
authors.initials: PJ
authors.lastname: McKiernan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004638:Emergency Treatment / Q000379:methods; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000628:therapy*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis; D007223:Infant; D008297:Male; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents