反復的な内視鏡的静脈瘤硬化療法により食道胃静脈瘤の退縮が得られた乳児胆道閉鎖症の 1

Translated title of the contribution: Successful repeated endoscopic injection sclerotherapy for severe esophagogastric varices in an infant with biliary atresia: A case report

Shinya Yokoyama, Takashi Honda, Teiji Kuzuya, Yoji Ishizu, Takanori Ito, Kenta Yamamoto, Taku Tanaka, Hisanori Muto, Yoshiaki Sugiyama, Mitsuhiro Fujishiro

Research output: Contribution to journalArticlepeer-review

Abstract

A 10-month-old boy with biliary atresia who had undergone the Kasai procedure, was admitted to our hospital due to tarry stool. We performed emergency esophagogastroduodenoscopy and found severe esophagogastric varices. There was a spurting bleeding site at the lower esophagus. We implemented endoscopic injection sclerotherapy (EIS) for esophagogastric variceal bleeding, since it was impossible to insert the scope through the esophagus with an endoscopic variceal ligation device attached. After performing four sessions of EIS, the patient developed esophageal ulcers and stricture related to EIS, leading to poor oral intake and body weight loss. We were able to manage these adverse events with conservative treatment. After healing of the esophageal ulcers and stricture, two additional sessions of EIS were performed. The patient's esophagogastric varices disappeared completely. Intra-variceal EIS followed by para-variceal EIS by polidocanol was reported to be effective and relatively safe for the treatment of esophageal varices in adult patients. The aim of paravariceal EIS is to form ulcers at the injection sites, resulting in the development of fibrosis of the mucosa during the healing process. This mucosal fibrosis is considered important for preventing recurrence of varices. There is little evidence for the safety and efficacy of intra-variceal EIS followed by para-variceal EIS in pediatric patients. Although we should be cautious of EIS-related stricture due to esophageal ulcer, especially in children who have a narrower esophageal lumen than adults, we have experienced a successful case of EIS for esophageal varices in an infant with biliary atresia.

Translated title of the contributionSuccessful repeated endoscopic injection sclerotherapy for severe esophagogastric varices in an infant with biliary atresia: A case report
Original languageJapanese
Pages (from-to)3064-3071
Number of pages8
JournalGASTROENTEROLOGICAL ENDOSCOPY
Volume62
Issue number12
DOIs
Publication statusPublished - 12-2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Fingerprint Dive into the research topics of 'Successful repeated endoscopic injection sclerotherapy for severe esophagogastric varices in an infant with biliary atresia: A case report'. Together they form a unique fingerprint.

Cite this