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Digestive bleeding
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Variceal bleeding is the most feared complication of portal hypertension (PH) in children. Digestive hemorrhage (DH) from ruptured esophageal (VO) or gastric (VG) varices is a pediatric emergency because it can threaten the child's vital prognosis. In this work we present the results of a retrospective study conducted in a Tunisian pediatric hepatology unit. The objective of this study was to describe the management of children presenting with ruptured OV or LV and to recall the principles of this management and the contribution of upper GI endoscopy in the treatment. PH was secondary to liver cirrhosis (54%) or portal cavernoma (46%). Hemorrhagic shock was noted in 21% of cases. Upper GI endoscopy (UGI) showed VO grade 1, 2 and 3 in 8%, 61% and 31% of cases respectively. LVs were objectified in 12% of cases. Elastic ligation of the VOs was performed in 27% of cases. Only one patient had LV obturation by biological glue. HRE is of diagnostic and therapeutic interest in HD due to VO or LV rupture in children.
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