Evaluation of the re bleeding average in pediatric patients with portal vein thrombosis that used endoscopic and/or prophylactic drug therapy/Avaliacao da media de ressangramento em pacientes pediatricos com trombose da veia porta que fizeram uso de profilaxia endoscopica e/ou medicamentosa

Introduction: Portal hypertension is a consequence of extra-hepatic portal vein obstruction, and portal vein thrombosis is its main etiology in pediatric age. The most feared portal hypertension complication is upper digestive hemorrhage caused by rupture of esophageal varicose veins. It's estimated that over 70-79 per cent of children with deep vein thrombosis (DVT) will present at least one episode of upper digestive hemorrhage on their lives. The approach is divided in: primary prophylaxis, treatment of acute hemorrhage episode and secondary prophylaxis. Available prophylactic methods are: pharmacologic, endoscopic therapy, and surgery. Objectives: Evaluate the rebleeding rate due to esophageal and/or gastric varicose veins rupture in patients using secondary prophylaxis with propanolol and/or endoscopic procedures/methods, followed up in IMIP's pediatric hepatology ambulatorial service. Methods: It's an analytical, and retrospective study, with the analysis of patient's medical records. A computer software "R" version 3.3.1. was used for the statistical analysis. Results: Rebleeding global rate was 1,5 times, in spite of prophylaxis's type used. The most utilized procedures for bleeding control were endoscopic treatment with sclerotherapy and elastic ligature (N=10) followed by endoscopic and drug therapy with propanolol (N=9). Analyzing rebleeding frequency, it can be noticed that patients which the only treatment realized was sclerotherapy presented re-bleed average of 2,16 times. Patients who realized only elastic ligature (N=2) or propanolol (N=3) had not presented new bleeding episodes. Conclusions: The present study reveals a small average of rebleeding in patients that used only elastic ligature or propanolol. However, new studies in pediatric age group are needed to evaluate the security and efficacy of specific methods. Keywords: Hypertension, portal; Esophageal gastric varices; Propanolol; Sclerotherapy; Ligation. Introducao: A hipertensao portal (HP) resulta da obstrucao venosa portal extra-hepatica cuja principal etiologia na faixa etaria pediatrica e a trombose da veia porta. A complicacao mais temida da HP e a hemorragia digestiva alta decorrente da ruptura das varizes esofagicas. Estima-se que cerca de 70-79% das criancas com Trombose de veia prota (TVP) apresentarao pelo menos um episodio de hemorragia digestiva alta durante sua vida. A abordagem e dividida da seguinte forma: profilaxia primaria, tratamento de episodios hemorragicos agu