Digestive Disease Interventions 2019; 03(03): 214-226
DOI: 10.1055/s-0039-1694978
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Endovascular and Percutaneous Treatment of Pediatric Portosystemic Varices: A Case Review

Alexander Dabrowiecki
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Eric J. Monroe
2   Department of Interventional Radiology, Seattle Children's Hospital, Seattle, Washington
,
Rene Romero
3   Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Children's Pediatric Institute, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
,
Anne E. Gill
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
4   Division of Interventional Radiology and Image Guided Medicine, Children's Pediatric Institute, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
,
C. Matthew Hawkins
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
4   Division of Interventional Radiology and Image Guided Medicine, Children's Pediatric Institute, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia
› Author Affiliations
Further Information

Publication History

10 April 2019

06 June 2019

Publication Date:
27 August 2019 (online)

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Abstract

Portal hypertension is a significant cause of morbidity and mortality in pediatric patients. Complications of portal hypertension include development of portosystemic varices. The most common type of portosystemic varices are gastroesophageal varices; however, other ectopic varices can also be a cause of recurrent, life-threatening gastrointestinal bleeding. Problematic ectopic varices include isolated gastric, anorectal, small bowel, roux-limb, and stomal varices. There are no standardized treatment guidelines on how to manage ectopic varices in children; however, new innovations in endovascular treatment options provide potential therapeutic alternatives when varices are refractory to conventional therapy. This review provides a case-based literature review for endovascular treatment of isolated gastric, anorectal, small bowel, roux-limb, and stomal ectopic varices in children (age 0-9 years) and adolescents (age 10-19 years).