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

Authors

  • 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
Further Information

Publication History

10 April 2019

06 June 2019

Publication Date:
27 August 2019 (online)

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).