Splenic artery embolisation for portal hypertension in children.
BACKGROUND
Bleeding from esophageal varices is one of the most common causes of serious gastrointestinal haemorrhage in children. We analysed our experience with the use of splenic artery embolisation and variceal sclerotherapy for bleeding oesophageal varices.


METHODS
Records of all patients treated for bleeding oesophageal varices caused by portal hypertension from 1998 to 2004 were retrospectively analysed. Patients were followed up for five years.


RESULTS
Out of 25 patients treated, ten belonged to sclerotherapy (group A), eight to combined sclerotherapy and embolisation (group B), and seven to only embolisation (group C). The patients were selected randomly, only two patients who had active bleed recently were directly sclerosed. The splenic artery was embolised at the hilum using steel coils in 15 patients with portal hypertension and hypersplenism. Follow-up findings showed decrease in splenic mass, varices, and hyperdynamic flow.


CONCLUSIONS
In spite of few patients and a short period of follow-up, our results pointed out that a serious consideration should be given to this procedure, as it slowed the sequel of portal hypertension and the complications associated with it. Patients who were embolised and followed up for five years had lesser rebleeds and complications than sclerotherapy patients.
Meisheri
Ila V
IV
Department of Paediatric Surgery, B. J. Wadia Children Hospital, India.
Kothari
Paras R
PR
Kumar
Anil
A
Deshmukh
A
A
D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000009:adverse effects / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000009:adverse effects / Q000379:methods*; D013157:Splenic Artery; D016896:Treatment Outcome
D012597:Sclerosing Solutions