Gastric variceal (GV) haemorrhage is one of the most serious complications of portal hypertension, with mortality ranging from 30% to 50%. Pediatric data focusing on endoscopic techniques to management are required. The current study is the first to provide a paediatric case series of endoscopic ultrasonography (EUS)-guided coil implantation within feeding arteries as monotherapy for GV haemorrhage. Using the prospectively kept endoscopic database, the researchers identified patients aged 18 and under who underwent EUS-guided coil installation for GV haemorrhage management. Demographics, indication, procedural interventions/findings, and available clinical outcomes data were all examined. For GV bleeding, 12 patients received EUS-guided coil implantation. All had portal hypertension, with EV at 58.3 percent and past GV haemorrhage with endoscopic treatment in 75%. A linear echoendoscope and a 19-gauge needle were used to instal the coil. All patients experienced immediate hemostasis, and 25% experienced recurrent gastric varices at a median of 5.5 months after the first EUS-guided coil implantation across a median 12-month follow-up period.

The current study proves the feasibility and efficacy of EUS-guided coil implantation as monotherapy for GV haemorrhage in children and adolescents. The treatment was technically successful, with all patients achieving primary hemostasis. EUS-guided embolization with coils may be a viable alternative to current techniques for the treatment of severe GV haemorrhage.

Reference: https://journals.lww.com/jpgn/Abstract/2021/04000/Initial_Experience_With_Endoscopic.9.aspx