J Korean Soc Emerg Med.  1999 Sep;10(3):466-471.

A Clinical Review of Esophageal Varix Bleeding Patient in Pediatric Emergency Center

• Kim SH
• Shin SD
• Pyo CH
• Rhee JE
• Suh GJ
• Jung SE
• Youn YK

Abstract

BACKGROUND: Varix bleeding in children is infrequent but it is potentially fatal. It has characteristics different from adult age varix bleeding. But there was little clinical data about it. The purposes of this study is to detect its characteristics of varix bleeding in pediatric patients, and to help an emergency physician make a decision about the management.
METHODS
We reviewed medical records of 32 patients who visit Seoul National University Hospital Pediatric Emergency center from Jan. 1, 1995 to Dec. 31, 1996.
RESULTS
1) The peak age was between 1 and 5 years of age, and the ration of males to females was 1: 1. 2) As a underlying cause, intrahepatic disease were more common than extrahepatic diseases(87.1%:12.9%). 3) 10 patients(31.3%) had URI symptoms as a precipitating factor. 4) Varix bleeding has a circardian rhythm, and occured more often during the night. 5) In Child Classification for the hepatic reserve fuction, Child C was the most common(75%). 6) Endoscopic eliminations were performed in 14 patients(43.8%). 7) According to shock classification. the ration of conservative to vasopressin treatment in class I and class II were 13(40.6%)/10(31.3%) and 6(18.8%)/3(9.4%), respectively. 8) Fever was the most common complication(43.8%), and the mortality rate was 3.1%.
CONCLUSION
We suggest that the only conservative management can show a good result far pediatric varix bleeding compared to other treatment modalities.

MeSH Terms

Adult
Child
Classification
Emergencies*
Esophageal and Gastric Varices*
Female
Fever
Hemorrhage*
Humans
Male
Medical Records
Mortality
Precipitating Factors
Seoul
Shock
Varicose Veins
Vasopressins
Vasopressins