Oesophageal Varices

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Abstract

Oesophageal varices develop as a result of portal hypertension. Variceal bleeding is the most common cause of severe gastrointestinal bleeding in childhood. In acute bleeding, pharmacotherapy with octreotide should be used immediately. All should undergo urgent therapeutic endoscopy, ideally with variceal band ligation. Transjugular intrahepatic portosystemic shunt should be reserved as rescue treatment. Following variceal haemorrhage, all children should undergo secondary prophylaxis with variceal band ligation. Where varices are due to extrahepatic portal venous obstruction, children should be assessed for suitability for mesoportal bypass. There is currently no evidence to support the routine use of primary prophylaxis in children with oesophageal varices, but there is an urgent need for studies in this group.

Keywords

Oesophageal varices Portal hypertension Collaterals Bleeding Endoscopy Clipping Causes Degree 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Liver UnitChildren’s Hospital NHS TrustBirminghamUK

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