Enfrentamiento de pacientes pediátricos con várices esofágicas

Background: There is a paucity of good quality research about the diagnosis of esophageal varices and the prophylaxis and treatment of variceal bleeding in pediatric patients with portal hypertension There is little consensus and practically no evidence-based approach about the management of these p...

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Autores principales:	Verdaguer D,Sofía, Gana A,Juan Cristóbal
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2016
Materias:	Diagnosis Esophageal and Gastric Varices Hypertension, Portal Pediatrics Primary Prevention Secondary Prevention
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000700008
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spelling	oai:scielo:S0034-988720160007000082016-10-03Enfrentamiento de pacientes pediátricos con várices esofágicasVerdaguer D,SofíaGana A,Juan Cristóbal Diagnosis Esophageal and Gastric Varices Hypertension, Portal Pediatrics Primary Prevention Secondary Prevention Background: There is a paucity of good quality research about the diagnosis of esophageal varices and the prophylaxis and treatment of variceal bleeding in pediatric patients with portal hypertension There is little consensus and practically no evidence-based approach about the management of these patients. Aim: To describe the behavior and preferences of pediatric gastroenterologists in Chile in the management of portal hypertension in children. Material and Methods: An online survey was sent to Chilean pediatric gastroenterologists, with questions evaluating the physicians approaches to screening of esophageal varices in children with portal hypertension, and their preferred methods of prophylaxis and initial management of variceal bleeding. Results: Thirty five of 69 contacted physicians answered the survey (51%). Twenty nine pediatric gastroenterologists (83%) screen for esophageal varices in patients with clinical evidence of portal hypertension, and 12 (34%) in every patient with chronic liver disease. Twenty eight respondents (80%) use primary prophylaxis, mainly beta blockers. Octreotide, proton pump inhibitors and endoscopy are the most common practices in the initial management of an esophageal varix bleed. The methods mostly used as secondary prophylaxis are band ligation and beta blockers. In the case of recurrent hemorrhage, besides band ligation, management with Transjugular Intrahepatic Portosystemic Shunt (TIPS) and hepatic transplantation are more likely. Conclusions: Even though most pediatric gastroenterologists in this survey are inclined to offer endoscopic screening of esophageal varices and prophylaxis to patients with portal hypertension, this is not a universal behavior. There are different approaches mainly in the election of secondary prophylaxis and the initial management of variceal bleeding.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.144 n.7 20162016-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000700008es10.4067/S0034-98872016000700008
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Diagnosis Esophageal and Gastric Varices Hypertension, Portal Pediatrics Primary Prevention Secondary Prevention
spellingShingle	Diagnosis Esophageal and Gastric Varices Hypertension, Portal Pediatrics Primary Prevention Secondary Prevention Verdaguer D,Sofía Gana A,Juan Cristóbal Enfrentamiento de pacientes pediátricos con várices esofágicas
description	Background: There is a paucity of good quality research about the diagnosis of esophageal varices and the prophylaxis and treatment of variceal bleeding in pediatric patients with portal hypertension There is little consensus and practically no evidence-based approach about the management of these patients. Aim: To describe the behavior and preferences of pediatric gastroenterologists in Chile in the management of portal hypertension in children. Material and Methods: An online survey was sent to Chilean pediatric gastroenterologists, with questions evaluating the physicians approaches to screening of esophageal varices in children with portal hypertension, and their preferred methods of prophylaxis and initial management of variceal bleeding. Results: Thirty five of 69 contacted physicians answered the survey (51%). Twenty nine pediatric gastroenterologists (83%) screen for esophageal varices in patients with clinical evidence of portal hypertension, and 12 (34%) in every patient with chronic liver disease. Twenty eight respondents (80%) use primary prophylaxis, mainly beta blockers. Octreotide, proton pump inhibitors and endoscopy are the most common practices in the initial management of an esophageal varix bleed. The methods mostly used as secondary prophylaxis are band ligation and beta blockers. In the case of recurrent hemorrhage, besides band ligation, management with Transjugular Intrahepatic Portosystemic Shunt (TIPS) and hepatic transplantation are more likely. Conclusions: Even though most pediatric gastroenterologists in this survey are inclined to offer endoscopic screening of esophageal varices and prophylaxis to patients with portal hypertension, this is not a universal behavior. There are different approaches mainly in the election of secondary prophylaxis and the initial management of variceal bleeding.
author	Verdaguer D,Sofía Gana A,Juan Cristóbal
author_facet	Verdaguer D,Sofía Gana A,Juan Cristóbal
author_sort	Verdaguer D,Sofía
title	Enfrentamiento de pacientes pediátricos con várices esofágicas
title_short	Enfrentamiento de pacientes pediátricos con várices esofágicas
title_full	Enfrentamiento de pacientes pediátricos con várices esofágicas
title_fullStr	Enfrentamiento de pacientes pediátricos con várices esofágicas
title_full_unstemmed	Enfrentamiento de pacientes pediátricos con várices esofágicas
title_sort	enfrentamiento de pacientes pediátricos con várices esofágicas
publisher	Sociedad Médica de Santiago
publishDate	2016
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000700008
work_keys_str_mv	AT verdaguerdsofia enfrentamientodepacientespediatricosconvaricesesofagicas AT ganaajuancristobal enfrentamientodepacientespediatricosconvaricesesofagicas
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Enfrentamiento de pacientes pediátricos con várices esofágicas

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