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Use of non-invasive scales for detecting esophageal varices in paediatric patients with portal vein thrombosis. / Utilización de escalas no invasivas en la detección de varices esofágicas en pacientes con trombosis venosa portal.
Diéguez Hernández-Vaquero, Irene; Domènech Tàrrega, Anna; Costa-Roig, Adrià; Couselo Jerez, Miguel; Vila Carbó, Juan José.
Afiliación
  • Diéguez Hernández-Vaquero I; Servicio de Cirugía Pediátrica, Hospital Universitari i Politècnic de La Fe, Valencia, España. Electronic address: irened1402@hotmail.com.
  • Domènech Tàrrega A; Servicio de Cirugía Pediátrica, Hospital Universitari i Politècnic de La Fe, Valencia, España.
  • Costa-Roig A; Servicio de Cirugía Pediátrica, Hospital Universitari i Politècnic de La Fe, Valencia, España.
  • Couselo Jerez M; Servicio de Cirugía Pediátrica, Hospital Universitari i Politècnic de La Fe, Valencia, España.
  • Vila Carbó JJ; Servicio de Cirugía Pediátrica, Hospital Universitari i Politècnic de La Fe, Valencia, España.
Article en En, Es | MEDLINE | ID: mdl-37562768
INTRODUCTION: Portal vein thrombosis (PVT) is the most frequent cause of portal hypertension in paediatric population. Baveno VI Consensus considers endoscopic variceal ligation as the second therapeutic option after meso-Rex bypass (surgical shunt). AIM: Analyse the diagnostic profitability of non-invasive scales in order to predict the risk of oesophageal varices (OV) in children with PVT. MATERIAL AND METHODS: Descriptive retrospective study where every upper gastrointestinal endoscopy (UGE) carried on patients <15 years old with non-cirrhotic PVT were included. There were divided according to the presence of OV and sex, cause, age, previous gastrointestinal bleeding or treatments, results of UGE and scales (Clinical Prediction Rule - CPR), Varices Prediction Rule - VPR), King's Variceal Prediction Score - K-VaPS) and Platelet count/Spleen diameter Ratio - PSR). Qualitative variables were expressed as absolute frequency and percentage, and quantitative variables as median and interquartile range. U Mann-Whitney and Hanley-McNeil tests were used for comparisons. RESULTS: Forty-five UGE were analysed. 80% (n=36) presented OV: median of 3 (2-3) and 33.3% (n=12) required endoscopic variceal ligation. Statistical differences were demonstrated between both groups: CPR (142.39 [132.22-166.53] vs. 122.75 [115.24-133.15]; p=0.003), VPR (9.91 [9.36-11.75] vs. 5.6 [3.34-8.39]; p=0.001), K-VaPS (117.86 [99.66-126.58] vs. 99.64 [94.88-10.18]; p=0.019), PSR (2384.62 [1902.22-3201.63] vs. 1252.5 [579.6-2144.42]; p=0.05), with and area under the curve AUROC>75%, without statistical differences between scales. CONCLUSIONS: In paediatric patients with non-cirrotic PVT non-invasive scales can be used as a tool to predict the presence of OV and raise the indication of UGE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Idioma: En / Es Revista: Gastroenterol Hepatol Año: 2023 Tipo del documento: Article Pais de publicación: España

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Idioma: En / Es Revista: Gastroenterol Hepatol Año: 2023 Tipo del documento: Article Pais de publicación: España