Abordagem das varizes de esôfago no paciente pediátrico cirrótico: rastreamento, profilaxia primária e conduta no sangramento agudo

The gastrointestinal bleeding from ruptured varices is the leading cause of morbidity and mortality in the cirrhotic patient.The knowledge of the evolution of portal hypertension and the natural story of gastro-esophageal varices allows a better approach to the cirrhotic patient that includes: scree...

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Detalles Bibliográficos
Autores: José Ricardo Borém Lopes, Thaís Costa Nascentes Queiroz, Eleonora Druve Tavares Fagundes, Priscila Menezes Ferri Liu, Alexandre Rodrigues Ferreira, Cristiana Guimarães Melo, Lucas Garcia de Figueiredo Colin
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:Brasil
Institución:Universidade Federal de Minas Gerais (UFMG)
Repositorio:Repositório Institucional da UFMG
Idioma:portugués
OAI Identifier:oai:repositorio.ufmg.br:1843/57189
Acceso en línea:http://hdl.handle.net/1843/57189
Access Level:acceso abierto
Palabra clave:Cirrose Hepática
Variz Gástrica
Crianças
Adolescentes
Descripción
Sumario:The gastrointestinal bleeding from ruptured varices is the leading cause of morbidity and mortality in the cirrhotic patient.The knowledge of the evolution of portal hypertension and the natural story of gastro-esophageal varices allows a better approach to the cirrhotic patient that includes: screening for varices with high risk of bleeding and recommendation of primary prophylaxis for gastrointestinal bleeding. If the bleeding occurs, the approach must be immediate using known protocols. This conduct is well established in the cirrhotic adult. In children due to the limited number of studies the management is based in adult protocols, which could not be adequate to this age range. It was made a non systematic review of scientific literature from 1998 due 2018, available in MEDLINE, PUBMED, Elsevier, Web of Science, Scielo and Lilacs.Although there is no clear recommendation about the screening for varices, there is an agreement to do an endoscopy in children with clinical or laboratory signs of portal hypertension and begin the primary prophylaxis in esophageal varices of medium-size and large-size. In the regard of the acute bleeding, there were few changes in the last years and the approach remains predominantly extrapolated of studies with the adult population.