ENDOSCOPIC VARICEAL LIGATION AS SECONDARY PROPHYLAXIS IN CHILDREN

AND ADOLESCENTS WITH ESOPHAGEAL VARICES

Eva Jeumpa Soelaeman1, Rifrita Fransisca Halim1, Ariani Dewi Widodo1, Budi Purnomo1,
1
Department of Pediatrics, Harapan Kita Women and Children Hospital, Jakarta, Indonesia

BACKGROUND
Bleeding of esophageal varices is the main cause of morbidity and mortality in children and
adolescents. Endoscopic Variceal Ligation (EVL) is effective to treat variceal bleeding
especially in a life threatening situation in children.

OBJECTIVE
This study was performed to report the prevalence and characteristics of endoscopic
variceal ligation at Harapan Kita Women and Children Hospital.

METHOD
This is a descriptive cross sectional study with consecutive sampling. Every children
underwent endoscopic variceal ligation at Harapan Kita Women and Child Hospital between
January 2015 – May 2019 was included in this study.

RESULTS
There are 12 patient underwent EVL during study period. From those 12 patients, the
average age of patients was 7.58 years (2-16 years); 8 patients (66,7%) were male and 4
patients (33,3%) were female. Prevalence of esophageal varices by grade was found, only 1
patient (8,3%) had grade I, 2 patients (16,7%) had grade I-II, 7 patients (58,3%) had grade
II-III and 2 patients (16,7%) had grade III-IV.
Only 1 patient (8,3%) experienced recurrent bleeding because of late follow-up. At the first
EVL, almost all patients had grade II-III esophageal varices. Four months later after the
evaluation we found 8 patients (66,7%) with grade I-II esophageal varices and 4 patients
(33,3%) with grade II-III esophageal varices. No further variceal bleeding was found in the
next evaluation.

CONCLUSION
Endoscopic variceal ligation is effective in controlling variceal hemorrhage in children and
adolescents, the recurrent bleeding rate in our center is as low as 10%.

Keyword: endoscopic variceal ligation; esophageal varices; sclerotherapy; child; adolescent