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Publication Type
Journal Article
UWI Author(s)
Author, Analytic
Ramphal, Paul S.; Lee, Michael G.; Rose, D. A.; Venugopal, Sivarajan
Author Affiliation, Ana.
Surgery, Radiology, Anaesthesia and Intensive Care
Article Title
Childhood portal hypertension in Jamaica.
Medium Designator
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Connective Phrase
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Journal Title
West Indian Medical Journal
Translated Title
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Reprint Status
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Date of Publication
1995
Volume ID
44
Issue ID
3
Page(s)
88-90
Language
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Connective Phrase
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Location/URL
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ISSN
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Notes
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Abstract
Portal hypertension and bleeding from oesophageal varices in children remain a difficult medical problem. The clinical course and management of children with portal hypertension seen over a 14-year period was reviewed. There were 5 females and 2 males with a mean age of 3.6 years at presentation. Five patients presented with severe upper gastrointestinal bleeding and two with severe hypersplenism. All patients had extra-hepatic portal hypertension. Five patients were treated with endoscopic sclerotherapy, including one who had bleeding five years post-splenectomy. A mean of 9 sclerotherapy sessions was performed in each patient. Complete obliteration of varices was not achieved in any patient and a single rebleeding episode occurred in four. Three children underwent operative management consisting of splenectomy in two and splenectomy and central spleno-renal shunt in one. There was no mortality in either group after a mean follow-up of 4.3 years. Sclerotherapy may not be totally successful in long-term management of childhood portal hypertension. Surgical therapy or a combination of sclerotherapy and surgery may be the best approach.....
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Keywords
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