During the past 3 2/3 yr, 6 children with portal vein
thrombosis were treated for esophageal
hemorrhage by direct injection of
esophageal varices with
sodium morrhuate (endosclerosis). Four children were actively hemorrhaging at the time of initial endosclerosis; 2 patients were treated electively. Endosclerosis was performed by (1) employment of an especially slotted rigid
esophagoscope, (2) direct intravariceal injection, (3) injection of
varices at the gastroesophageal junction only. In patients actively hemorrhaging, endosclerosis was repeated every 3 to 4 days until the
bleeding ceased. Once
bleeding was controlled the procedure was done at 6-wk intervals until
esophageal varices were obliterated. In the four patients actively hemorrhaging,
bleeding was controlled by 2 to 3 separate injection sessions. Four patients have completed treatment and
varices are absent radiographically and endoscopically. No patient has rebled during or
after treatment in follow-up from 1/6 to 3 2/3 yr. Esophageal endosclerosis is advocated as a legitimate alternative to
portosystemic shunt operations and nonoperative management of esophageal variceal
hemorrhage in children with portal vein
thrombosis.