| Pediatric gastroesophageal varices: treatment strategy and long-term results. | |
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MedLine Citation:
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PMID: 17161186 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/PURPOSE: There are various treatment strategies for gastroesophageal varices in children. We studied the therapeutic value of endoscopic variceal clipping (EVC) and ligation (EVL). METHODS: Four hundred ninety-nine endoscopic examinations performed between 1991 and 2005 were retrospectively analyzed. F2 and F3 varices with red color signs on follow-up endoscopy were treated with prophylactic EVC. In variceal rupture cases, EVC and EVL were used in combination. RESULTS: Eighty-two prophylactic EVCs were done, and variceal progression was prevented in 89.9%. However, some patients had persistent red color signs and required frequent EVC. Ten emergent procedures were done for variceal rupture, and, in 4 cases, EVL was used to arrest massive variceal bleeding. Five patients developed bleeding during follow-up cause by rupture of gastric fundal varices, which probably had been aggravated by prior treatment for esophageal varices. CONCLUSIONS: The control of gastroesophageal varices by routine EVC was satisfactory. However, ruptures during follow-up suggested the importance of controlling gastric fundal varices. Endoscopic variceal ligation is a simple, effective, and safe treatment tool, particularly for ruptured varices. However, it is difficult to treat gastric fundal varices with EVL; this disadvantage of EVL can be overcome by the concomitant use of EVC. |
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Authors:
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Tetsuya Mitsunaga; Hideo Yoshida; Katsunori Kouchi; Tomoro Hishiki; Takeshi Saito; Shin-ichi Yamada; Yoshiharu Sato; Keita Terui; Mitsuyuki Nakata; Ayako Takenouchi; Naomi Ohnuma |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 41 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-12-12 Completed Date: 2007-01-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1980-3 Citation Subset: IM |
Affiliation:
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Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. tetsuya@z.email.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Child, Preschool Esophageal and Gastric Varices / complications, therapy* Gastrointestinal Hemorrhage / etiology, therapy* Gastroscopy* Humans Infant Ligation Retrospective Studies Rupture, Spontaneous Surgical Instruments Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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