HANDLING OF ESOPHAGEAL VARICES IN CHILDREN

: We present a discussion of the different therapeutical methods known for children who suffer Portal Hypertension and Esophageal varices, putting special emphasis on the handling of digestive bleeding. We are also taking into account that there are important differences and similarities between the paediatric and adult populations in the handling of diagnosis as well as in the therapy.Upper Digestive Hemorrhage due to esophageal varice rupture is the major and most expectacular complication of Portal Hypertension in children, being the extrahepatic obstruction the most frequent etiology in our population. Hemorrhage due to varices is generally observed in 2?year?old children, rarely in infants, except for those cases where the etiology is intrahepatic.Lately, Sclerotherapy has become the fundamental basis for the treatment of esophageal varices. With this therapy, the relapse of early or late bleedings is rare, allowing to increase survival in those cases where the origin is intrahepatic, and it offers a better prognosis in theextraheptatic ones. This is the procedure regarding which we have the most experience.Other methods are mentioned as the varice endoligatation, the use of drugs and surgical handling which are still limited.