title: Survey on Clinical Practice of Primary Prophylaxis in Portal Hypertension in Children.
abstract: Primary prophylaxis in portal hypertension in children is controversial, because there are few studies documenting its efficacy on the risk of bleeding. Twenty-eight centres out of the 38 we contacted returned a completed questionnaire about their clinical practices. More than 75% of the centres use endoscopy to screen patients diagnosed with portal cavernoma, biliary atresia, cystic fibrosis, and other fibrotic chronic liver diseases with suspected portal hypertension. In cases of grade 2 varices with red marks and grade 3 varices >90% of centres perform sclerotherapy or endoscopic variceal ligation. Noncardioselective beta-blockers were used by approximately 20% of centres. In conclusion, despite the absence of scientific recommendations there is a tacit consensus concerning the need to screen children with clinical signs of portal hypertension, and to provide primary prophylaxis in cases of endoscopic patterns of high-risk varices.
authors: *Department of Digestive Endoscopy, AP-HM Hôpital de la Timone Adulte †Department of Digestive Endoscopy, Hôpital Européen ‡Department of Digestive Endoscopy, Hôpital Privé Beauregard, Marseille §Department of Paediatric Hepatology and National Referral Centre for Biliary Atresia and Paediatric Radiology, AP-HP Hôpital Bicêtre, Le Kremlin-Bicêtre ||Paris-Sud 11 University, Orsay, France ¶Department of Multidisciplinary Paediatrics, AP-HM Hôpital de la Timone Enfant, Marseille, France.
authors: Odile
authors: O
authors: Jeanniard-Malet
authors: Mathieu
authors: M
authors: Duché
authors: Alexandre
authors: A
authors: Fabre
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005602:France; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D007223:Infant; D008026:Ligation; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011322:Primary Prevention / Q000379:methods / Q000706:statistics & numerical data*; D011792:Quebec; D015911:Sclerotherapy; D013557:Switzerland
chemical_list: D000319:Adrenergic beta-Antagonists