ABSTRACT
The most common medications used to prevent variceal bleeding are non-selective beta-blockers. Although commonly used in adults with medium to large esophageal varices, there are little data regarding this practice in children with esophageal varices. Endoscopic variceal ligation (EVL) and sclerotherapy are invasive approaches for primary or secondary prophylaxis of esophageal varices. EVL or sclerotherapy are acute treatment options for bleeding esophageal varices. Patients most often present with signs or symptoms of chronic liver disease and cirrhosis, but they may also be asymptomatic until the initial gastrointestinal (GI) bleed occurs, manifesting as hematemesis, melena, hematochezia, or pallor and fatigue. Octreotide is used to decrease GI bleeding through vasoconstriction of the splanchnic circulation. The avoidance of medical prophylaxis in children is because children rely almost exclusively on tachycardia to maintain cardiac output when bleeding occurs, as stroke volume is relatively fixed.
