Carolyne Ghobrial1, Mohamed Rabea2, Nabil Mohsen3, Ayman Eskander3. 1. Departments of Pediatrics, Kasr Alainy School of Medicine, Cairo University. Electronic address: cmiga82@yahoo.com. 2. National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt. 3. Departments of Pediatrics, Kasr Alainy School of Medicine, Cairo University.
Abstract
BACKGROUND/ PURPOSE: Gastric antral vascular ectasia (GAVE) can cause recurrent bleeding and chronic anemia in children with portal hypertension (PHT). We aimed to evaluate the efficacy of EBL in comparison to argon plasma coagulation (APC) in children with PHT, bleeding from GAVE. METHODS: This prospective comparative study included 40 children with PHT who presented with nonvariceal GIT bleeding from GAVE. Patients were divided into 2 groups, each including 20 cases: one group was managed with APC and the other with EBL. Endoscopy was repeated every 3-4 weeks until complete ablation of GAVE. Patients were reevaluated earlier in the event of recurrence of bleeding or in case of severe anemia necessitating blood transfusion. A follow-up endoscopy was done 6 months after the last APC or EBL session. RESULTS: The ages ranged between 2 and 16 years. The EBL group required a significantly lower number of sessions for complete obliteration of the lesions (1.85 ± 0.81) as compared to APC group (4.15 ± 1.22), p < 0.05. EBL was superior to APC as regards shorter procedure time (p = 0.001), lower blood transfusion requirement (p < 0.05), less hospitalization (p < 0.05) and significantly lower recurrence rate of GAVE after 6 months of follow up (p = 0.01) CONCLUSIONS: EBL is more effective and time saving when compared to APC in treatment of bleeding from GAVE in children. LEVELS OF EVIDENCE: Treatment study, Level II (prospective comparative study).
BACKGROUND/ PURPOSE: Gastric antral vascular ectasia (GAVE) can cause recurrent bleeding and chronic anemia in children with portal hypertension (PHT). We aimed to evaluate the efficacy of EBL in comparison to argon plasma coagulation (APC) in children with PHT, bleeding from GAVE. METHODS: This prospective comparative study included 40 children with PHT who presented with nonvariceal GIT bleeding from GAVE. Patients were divided into 2 groups, each including 20 cases: one group was managed with APC and the other with EBL. Endoscopy was repeated every 3-4 weeks until complete ablation of GAVE. Patients were reevaluated earlier in the event of recurrence of bleeding or in case of severe anemia necessitating blood transfusion. A follow-up endoscopy was done 6 months after the last APC or EBL session. RESULTS: The ages ranged between 2 and 16 years. The EBL group required a significantly lower number of sessions for complete obliteration of the lesions (1.85 ± 0.81) as compared to APC group (4.15 ± 1.22), p < 0.05. EBL was superior to APC as regards shorter procedure time (p = 0.001), lower blood transfusion requirement (p < 0.05), less hospitalization (p < 0.05) and significantly lower recurrence rate of GAVE after 6 months of follow up (p = 0.01) CONCLUSIONS: EBL is more effective and time saving when compared to APC in treatment of bleeding from GAVE in children. LEVELS OF EVIDENCE: Treatment study, Level II (prospective comparative study).
Authors: Jean M Chalhoub; Jalaluddin Umar; Kevin Groudan; Nour Hamadeh; David J Desilets; Yesenia Greeff Journal: United European Gastroenterol J Date: 2021-02-18 Impact factor: 4.623
Authors: Dhiraj Tripathi; Adrian J Stanley; Peter C Hayes; Simon Travis; Matthew J Armstrong; Emmanuel A Tsochatzis; Ian A Rowe; Nicholas Roslund; Hamish Ireland; Mandy Lomax; Joanne A Leithead; Homoyon Mehrzad; Richard J Aspinall; Joanne McDonagh; David Patch Journal: Gut Date: 2020-02-29 Impact factor: 23.059