Management of portal hypertension.
Indian J Pediatr
;
2002 Sep; 69(9): 809-13
Article
in English
| IMSEAR
| ID: sea-79304
ABSTRACT
Portal hypertension (PHT) is common in children and a majority of cases in India are constituted by extrahepatic portal venous obstruction or cirrhosis of liver. Morbidity and mortality in this condition is related to variceal bleeding, most commonly from esophageal varices. Acute variceal bleeding is best controlled by endoscopic therapy. Somatostatin and octreotide are useful in acute variceal bleeding as a supplementary therapy. Acute variceal bleeding uncontrolled by medical therapy merits preferably a shunt surgery or devascularization depending upon etiology of PHT and expertise of the surgeon. Acute variceal bleeding originating from gastric varices can be effectively controlled by endoscopic injection of tissue adhesive agent (n-butyl 2 cyanoacrylate). Eradication of esophageal varices by endoscopic measures (sclerotherapy or band ligation) is successful in prevention of recurrence of bleeding. Surgical portosystemic shunts especially in non-cirrhotic PHT are successful in achieving portal decompression and significant reduction in recurrence of variceal bleeding. Role of beta-blockers in primary prophylaxis of variceal bleeding in children still remains to be substantiated.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Prognosis
/
Severity of Illness Index
/
Female
/
Humans
/
Male
/
Somatostatin
/
Vasopressins
/
Portasystemic Shunt, Surgical
/
Octreotide
/
Child
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Journal:
Indian J Pediatr
Year:
2002
Type:
Article
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