Endoscopic injection sclerotherapy for esophageal variceal bleeding in children with extrahepatic portal vein obstruction

From October 1989 to March 1994, 30 endoscopic injection sclerotherapies were performed in four consecutive female children who had extrahepatic portal vein obstruction complicated with esophageal variceal bleeding. Eradication of varices was achieved in three patients. However, bleeding occurred again in two of these patients due to esophageal varix recurrence. One patient, who discontinued sclerotherapy because of hemoptysis during treatment, also had 12 episodes of esophageal bleeding which were controlled by shunt therapy. In addition to hemoptysis, other complications were bleeding during sclerotherapy and fever. The sclerotherapy complication rate in this study was 17%. Our results suggest that endoscopic injection sclerotherapy is an effective and safe method for the prevention of variceal bleeding in children with extrahepatic portal vein obstruction. Long-term regular endoscopy follow-up and even repeated sclerotherapy are needed to prevent bleeding due to recurrence of esophageal varices.