Kim Seung Jin, Kim Kyung Mo
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2013 Mar;16(1):1-9. doi: 10.5223/pghn.2013.16.1.1. Epub 2013 Mar 31.
Variceal bleeding results in significant morbidity and mortality in both children and adults. The guidelines for the management of variceal bleeding are well established in adults but not in children as there have been insufficient pediatric studies of this disorder. In addition, the adult guidelines for treatment of variceal bleeding cannot be applied directly to children as the etiology and natural course of this disease differs between children and adults. Examples of recommended treatments in children include endoscopic variceal ligation as secondary prophylaxis for biliary atresia whereas a meso-Rex shunt operation for extrahepatic portal vein obstruction. In this review, we discuss prophylaxis options and some technical aspects of endoscopic management for variceal bleeding in children.
静脉曲张出血在儿童和成人中都会导致显著的发病率和死亡率。成人静脉曲张出血的管理指南已经确立，但儿童方面尚未确立，因为针对这种疾病的儿科研究不足。此外，成人静脉曲张出血的治疗指南不能直接应用于儿童，因为这种疾病在儿童和成人中的病因及自然病程有所不同。儿童推荐治疗的例子包括内镜下静脉曲张结扎术作为胆道闭锁的二级预防措施，以及用于肝外门静脉阻塞的肠系膜-雷克斯分流术。在本综述中，我们讨论了儿童静脉曲张出血的预防选择以及内镜管理的一些技术方面。
