Endoscopic treatment of gastroesophageal varices in young infants with cyanoacrylate glue: a pilot study.
BACKGROUND
In children, endoscopic sclerotherapy and variceal ligation (EVL) are the most used techniques for the treatment of gastroesophageal variceal bleeding (VB). However, these techniques achieve poor results in cases of gastric variceal bleeding, and EVL is not applicable in young infants.


OBJECTIVE
Our purpose was to evaluate the feasibility, efficacy, and safety of cyanoacrylate glue injection for the treatment of gastroesophageal varices in young infants.


METHODS
Single-center prospective study.


METHODS
From 2001 to 2005, 8 young infants (<or=2 years old, <or=10 kg) with portal hypertension and gastroesophageal varices underwent treatment with N-butyl-2-cyanoacrylate.


METHODS
Demographic data and the results were registered and analyzed at 1, 6, and 12 months after treatment.


RESULTS
The mean age and weight were 1.3 +/- 0.42 years (range 0.8 to 1.9 years) and 8.5 +/- 1.6 kg (range 5.5 to 10 kg). Glue injection was successfully performed in all infants. The mean volume injected was 1.15 +/- 0.62 mL (range 0.5 to 2 mL). Immediate control of bleeding was achieved in all cases. Ulcer bleeding as a complication was observed in 1 case. Varices relapse with bleeding was observed in 3 of 8 (37.5%) patients after a mean of 12.5 +/- 10.6 weeks (range 5 to 20 weeks). Patients with variceal rebleeding were retreated. Varices eradication was achieved in all cases after a mean of 1.4 +/- 0.52 sessions (range 1 to 2 sessions).


CONCLUSIONS
Open prospective series with a relatively small number of patients.


CONCLUSIONS
In young infants, the use of cyanoacrylate glue is safe and effective for the treatment of gastroesophageal VB.
Rivet
Christine
C
Department of Pediatrics, Division of Gastroenterology and Nutrition, Hôpital Edouard Herriot, Lyon, France.
Robles-Medranda
Carlos
C
Dumortier
Jérôme
J
Le Gall
Catherine
C
Ponchon
Thierry
T
Lachaux
Alain
A
D001656:Biliary Atresia / Q000150:complications; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004659:Enbucrilate / Q000627:therapeutic use; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000151:congenital; D007223:Infant; D007459:Iodized Oil; D008297:Male; D010865:Pilot Projects; D011169:Portal Vein; D011446:Prospective Studies; D012008:Recurrence; D019233:Retreatment; D015911:Sclerotherapy / Q000379:methods*; D013927:Thrombosis / Q000150:complications; D014014:Tissue Adhesives / Q000627:therapeutic use; D019896:alpha 1-Antitrypsin Deficiency / Q000150:complications
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C421460:glubran; D007459:Iodized Oil; D004659:Enbucrilate