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.
Design
Single-center prospective study.
Patients
From 2001 to 2005, 8 young infants (≤2 years old, ≤10 kg) with portal hypertension
and gastroesophageal varices underwent treatment with N-butyl-2-cyanoacrylate.
Main Outcome Measurements
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).
Limitations
Open prospective series with a relatively small number of patients.
Conclusion
In young infants, the use of cyanoacrylate glue is safe and effective for the treatment
of gastroesophageal VB.
Abbreviations:
EVL (endoscopic variceal ligation), EVS (endoscopic variceal sclerotherapy), IGV (type II gastric varices), GOV (type 1 gastric varices), GV (gastric varices), PELD (pediatric end-stage liver disease), VB (variceal bleeding)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 19, 2009
Accepted:
July 10,
2008
Received:
May 26,
2008
Lyon, FranceFootnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
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Identification
Copyright
© 2009 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
