Abstract

Digestive tract bleeding is the most frequent cause for emergency upper endoscopy in paediatrics. In patients with portal hypertension bleeding is caused by oesophageal or gastric varices. Bleeding secondary to gastric varices has a low incidence, but it is associated with high morbidity and mortality. The treatment of choice for these varices is with N-butyl-2-cyanoacrylate injection, a tissue adhesive frequently used in adults for primary and secondary prophylaxis. To evaluate the safety and efficacy of cyanoacrylate use in primary and secondary prophylaxis of gastric varices in children in a third-level hospital, and its effect on oesophageal varices. A case series that included 12 paediatric patients with portal hypertension and gastric varices that were treated with cyanoacrylate from January 2011 to February 2016. The study included 4 girls and 8 boys, with a mean age of 7 years old. Cyanoacrylate was used in 3 patients as primary prophylaxis for gastric varices, and as secondary prophylaxis for the rest. Gastric varices eradication was reported in 66.7% of patients, with 75% of those after only one injection. There were no episodes of bleeding or re-bleeding, or major complications. Cyanoacrylate use in primary and secondary prophylaxis of gastric varices in children was shown to be both safe and effective.