Urmi Roy¹*, Aniruddha Mondal², Khondaker Mobasher Ahmed³, MD Rukunuzzaman⁴ and Wahiduzzaman Mazumder⁵

¹Registrar, Department of Pediatric, Kurmitola General Hospital, Dhaka, Bangladesh
²Assistant Registrar, Department of Physical Medicine National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
³Assistant Professor (Pediatric Gastroenterology and Nutrition), Comilla Medical College, Cumilla, Bangladesh
⁴Head of the Department Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
⁵Associate Professor, Department of Paediatric Gastroenterolog and Nutrition, Bangabandhu Seikh Mujib medical University (BSMMU), Dhaka, Bangladesh

*Corresponding Author: Urmi Roy, Registrar, Department of Pediatric, Kurmitola General Hospital, Dhaka, Bangladesh.

Received: November 07, 2023; Published: November 20, 2023

Abstract

Background: Chronic Liver Disease (CLD) is a distressing medical condition that affects millions of children worldwide, posing significant challenges to their health and well-being. Among the myriad complications that can arise from CLD, esophageal varices represent a critical concern. Esophageal varices are abnormal, enlarged blood vessels in the esophagus that can rupture, leading to life-threatening hemorrhage. While much research has focused on adult populations, relatively limited attention has been given to understanding esophageal varices in pediatric patients with CLD. Esophageal varices are a potentially fatal consequence of CLD, with the risk of bleeding being a significant concern. Early detection and management are essential to prevent severe complications.

Aim of the study: This study aims to bridge this knowledge gap by conducting a comprehensive comparative analysis of esophageal varices' performance in children with CLD.

Methods: This cross-sectional study was conducted over two years, from April 2019 to October 2021, at the Department of Pediatric Gastroenterology and Nutrition at Bangabandhu Sheikh Mujib Medical University (BSMMU) in Dhaka, Bangladesh. It included 32 patients diagnosed with Chronic Liver Disease (CLD), categorized into two groups: Group A (Patients without Esophageal Varices) and Group B (Patients with Esophageal Varices). Each patient underwent a comprehensive clinical assessment, including physical examinations and data collection, with informed consent and ethical approval. Inclusion criteria covered patients under 18 with diagnosed chronic liver disease, while exclusion criteria ruled out those with gastrointestinal bleeding history, prior varices treatment, or severe ascites. Data analysis employed SPSS software, presenting findings with various statistical measures, such as frequency, percentage, and Chi-square or Mann-Whitney U tests as appropriate.

Result: In a study of 32 patients, 75% had esophageal varices with varying grades, and 25% did not. Gender distribution showed 62.5% males in Group A and 79.2% in Group B. Both groups had a similar age distribution. Consanguinity was found in all Group B patients, and jaundice history was prevalent in both groups. Liver disease history was more common in Group A. Anemia rates were 37.5% in Group A and 58.3% in Group B. Stigmata were significantly more common in Group B. Palpable spleens were significantly more common in Group B. None in Group A had ascites, while 75% of Group B had ascites. Diagnoses included Wilson's disease, Chronic hepatitis B, Autoimmune hepatitis, Cryptogenic cirrhosis, Biliary cirrhosis, and Glycogen storage disease. Hemoglobin values and total counts did not differ significantly. Platelet count was higher in Group A. Group A had lower bilirubin levels, while albumin was higher. Prothrombin time and INR were higher in Group B. At the same time, liver stiffness and serum fibrosis scores were significantly higher in Group B. Child-Pugh scores showed significant differences between the groups.

Conclusion: This study sheds light on the critical significance of early detection and comprehensive care for esophageal varices in children with Chronic Liver Disease (CLD). Collaboration among pediatric specialists is pivotal for effective management. Future research should focus on innovative approaches to enhance the quality of life and outcomes for these vulnerable patients.

 Keywords: Comparative Study; Performance; Esophageal Varices; Pediatric Patients and Chronic Liver Disease (CLD)

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Citation

Citation: Urmi Roy., et al. “ A Comparative Study on the Performance of Esophageal Varices in Pediatric Patients with Chronic Liver Disease (CLD)”. Acta Scientific Paediatrics 6.10 (2023): 24-32.

Copyright

Copyright: © 2023 Urmi Roy., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.