Harouchi A, Bellakhdar A
Chir Pediatr. 1980;21(6):377-82.
Bleeding esophageal varices in 7 children (5 with extra-hepatic obstruction and 2 with intra-hepatic obstruction) were treated by ligation of the esophagus on a Murphy button. Two patients died, one presenting mesenteric infarction following splenectomy, the other due to mismanagement of post-operative esophagus stenosis. Among the 5 surviving patients, the fact that no recurrent bleeding was noted and the complete disappearance of varices on X ray and endoscopy with a 2-6/12 year follow up demonstrate the efficiency of this treatment. The authors stress upon the precautions enabling to reduce the morbidity of this procedure (esophageal stenosis) giving otherwise good result in the management of bleeding esophageal varices in children.
7名儿童(5名肝外梗阻和2名肝内梗阻)的食管静脉曲张出血采用墨菲氏钮食管结扎术治疗。2例患者死亡,1例脾切除术后出现肠系膜梗死,另1例因术后食管狭窄处理不当死亡。在5名存活患者中,随访2至6/12年期间未发现复发出血,X线和内镜检查显示静脉曲张完全消失,证明了该治疗方法的有效性。作者强调了一些预防措施,这些措施能够降低该手术(食管狭窄)的发病率,而该手术在儿童食管静脉曲张出血的治疗中总体效果良好。