| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000415058 |
| ISSN: | 1665-2681 |
| Authors: | Flores Calderón, Judith1 Moran Villota, Segundo1 Rouassant, Solange Heller2 Nares Cisneros, Jesús3 Zárate Mondragón, Flora4 González Ortiz, Beatriz1 Chávez Barrera, José Antonio1 Vázquez Frias, Rodrigo5 Martínez Marín, Elsa Janeth6 Nora Marín-Rentería7 Bojórquez Ramos, María del Carmen8 Castillo De León, Yolanda Alicia8 Ortiz Galván, Roberto Carlos1 Varela Fascinetto, Gustavo9 |
| Institutions: | 1Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, México, Distrito Federal. México 2Centro Nacional para la Salud de la Infancia y la Adolescencia, México, Distrito Federal. México 3Instituto Mexicano del Seguro Social, Hospital de Especialidades 71, Torreón, Coahuila. México 4Instituto Nacional de Pediatría, Departamento de Gastroenterología, México, Distrito Federal. México 5Hospital Infantil de México "Federico Gómez", Departamento de Gastroenterología, México, Distrito Federal. México 6Hospital Infantil de México "Federico Gómez", Departamento de Endoscopia, México, Distrito Federal. México 7Hospital para el Niño Poblano, Puebla. México 8Instituto Mexicano del Seguro Social, Centro Médico de Occidente, Guadalajara, Jalisco. México 9Hospital Infantil de México "Federico Gómez", Departamento de Cirugía de Trasplantes, México, Distrito Federal. México |
| Year: | 2013 |
| Volumen: | 12 |
| Pages: | 3-3s24 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | Extrahepatic portal vein obstruction is an important cause of portal hypertension among children. The etiology is heterogeneous and there are few evidences related to the optimal treatment. Aim and methods. To establish guidelines for the diagnosis and treatment of EHPVO in children, a group of gastroenterologists and pediatric surgery experts reviewed and analyzed data reported in the literature and issued evidence-based recommendations. Results. Pediatric EHPVO is idiopathic in most of the cases. Digestive hemorrhage and/or hypersplenism are the main symptoms. Doppler ultrasound is a non-invasive technique with a high degree of accuracy for the diagnosis. Morbidity is related to variceal bleeding, recurrent thrombosis, portal biliopathy and hypersplenism. Endoscopic therapy is effective in controlling acute variceal hemorrhage and it seems that vasoactive drug therapy can be helpful. For primary prophylaxis of variceal bleeding, there are insufficient data for the use of beta blockers or endoscopic therapy. For secondary prophylaxis, sclerotherapy or variceal band ligation is effective; there is scare evidence to recommend beta-blockers. Surgery shunt is indicated in children with variceal bleeding who fail endoscopic therapy and for symptomatic hypersplenism; spleno-renal or meso-ilio-cava shunting is the alternative when Mesorex bypass is not feasible due to anatomic problems or in centers with no experience. Conclusions. Prospective control studies are required for a better knowledge of the natural history of EHPVO, etiology identification including prothrombotic states, efficacy of beta-blockers and comparison with endoscopic therapy on primary and secondary prophylaxis |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Pediatría, Sistema cardiovascular, Terapéutica y rehabilitación, Guías diagnósticas, Guías terapéuticas, Hipertensión portal, Oclusion vascular, Vena portal, Profilaxis |
| Keyword: | Medicine, Cardiovascular system, Gastroenterology, Pediatrics, Therapeutics and rehabilitation, Diagnostic guidelines, Therapeutic guides, Portal hypertension, Vascular occlusion, Portal vein, Prophylaxis |
| Full text: | Texto completo (Ver PDF) |
