Summary
A multicenter study over a period of 20 years for 3487 children demonstrated: Esophageal varizes occur in infants before the age of 6 months (8%). In contrast to adults, infants can suffer from intrahepatic biliary atresias and from alpha-1-antitryp-sin-deficiency. Leading to a liver fibrosis and to a hepatofugal circulation. This does not always lead to esophageal varizes. 15% of all children have this asymptomatic follow up. The rest of 85% can be treated successfully concervatively and in 15% by sclerotherapy. Further treatment: local thrombectomy or familiar liver partial transplantation.
Zusammenfassung
Eine multizentrische Untersuchung über 20 Jahre an 3487 Kindern ergab: Ösophagusvarizen können bei Säuglingen unter 6 Monaten (8%) auftreten. Im Gegensatz zu Erwachsenen gibt es bei Kindern Erkrankungen der Leber, z.B. Gallen-gangsatresien oder Alpha-1-Antitrypsin-Mangel, die zu einer Leberfibrose und einem hepatofugalen Umgehungskreislauf führen, der sich physiologisch entwickelt und nicht immer zu Ösophagusvarizen führt. 15% der Kinder zeigen diesen Verlauf. 85% der Kinder, die bluten, ist in 15% die Sklerosierungstherapie in 83% erfolgreich. Weitere Maßnahmen: Thrombektomie bei prähepatischem Block. Familiäre Leberteiltransplantation bei Gallengangsatresien und metabolischen Stoffwechselstörungen befinden sich in Entwicklung.
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© 1990 Springer-Verlag Berlin Heidelberg
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Willital, G.H. (1990). Ösophagusvarizen im Kindesalter. In: Ungeheuer, E. (eds) Deutsche Gesellschaft für Chirurgie. Langenbecks Archiv für Chirurgie Gegründet 1860 Kongreßorgan der Deutschen Gesellschaft für Chirurgie, vol 1990. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-48163-5_79
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DOI: https://doi.org/10.1007/978-3-642-48163-5_79
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