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Preventing variceal bleeds

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. GROOVE is designed to help provide answers about the. Best prevention for bleeding from varices in children. We provide below some details about the pros and cons of these treatments. Endoscopic variceal ligation (EVL). Many paediatric liver specialists think that EVL is an effective treatment for esophageal varices, based on their own experience and some published reports of its use in children. However, there is no conclu...

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About GROOVE

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. GROOVE aims to determine the best way to treat children with esophageal varices so as to prevent variceal bleeding. Our results will provide much-needed evidence to support the development of clinical practice guidelines that will enhance the quality of care for children with varices around the world. Therefore, we plan to use a registry approach that will benefit from the variation in practice among paediatric gastroenterologi...

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Treating variceal bleeds

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. Bleeding from varices is a medical emergency. When it occurs, the affected child should be moved urgently to the nearest hospital. It is usually best to call an emergency ambulance. A variceal bleed causes vomiting of blood, and/or passage of abnormal stools. The stools may be black, tarry or sticky, and have an unusual metallic smell. The child will usually be treated with many or all of the following:. A blood transfusion,.

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Grading varices

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. For children included In GROOVE, investigators will grade the size of varices using the Cales classification. This classification system was chosen because it is the best validated of all variceal grading systems and it provides better inter-observer agreement compared with quantitative grading (2). The Cales classification uses a semiquantitative grading system, based on two criteria:. Gastric or duodenal varices. These varice...

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Portal vein thrombosis

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. The reason why the blood clot forms is often not known ("idiopathic" portal vein thrombosis). However, sometimes it may occur in association with one or more risk factors, including:. Infection of the umbilicus in a newborn infant. Previous need for Insertion of an intravenous catheter into the umbilicus during the newborn period (e.g. in a sick, premature infant). Presence of a liver abscess or other severe liver infection.

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Normal liver blood flow

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. Normal liver blood flow. See definitions below for any words that you may not understand. Blood is pumped from the heart in arteries to all the organs in the body, including the liver, spleen and intestines. This blood travels to the liver in the hepatic artery, to the spleen in the splenic artery, and to the intestines in the mesenteric arteries. Normal liver blood flow. Inside the liver, the portal vein divides multiple times...

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Other complications

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. In addition to esophageal varices, portal hypertension is associated with several other complications that are detailed here. Hypersplenism may contribute to the increased risk of bleeding in children with liver disease, especially when the platelet count drops to very low levels. Children with liver disease that causes cirrhosis are prone to a build up of fluid within the abdomen, called ascites. The fluid accumulates betw...

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Data entry

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. A link to REDCap will appear here soon.

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Varices and bleeding

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. Varices are enlarged veins that develop in the wall of the esophagus or stomach in some children with cirrhosis or portal vein thrombosis. In these children with portal hypertension, some or all of the blood that usually flows through the liver must find an alternative route to get back to the heart. As these varices grow larger to carry more blood, the wall becomes stretched thinner and thinner. Eventually the wall of the ...

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GROOVE Info for patients

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Global Registry For Outcomes of Varices in Children. Normal liver blood flow. Information for patients and family members. Children with liver disease or portal vein thrombosis may develop portal hypertension and may be at risk for bleeding from enlarged veins (varices) in the esophagus (food pipe) or stomach. If your doctor has told you that you or your child has portal hypertension or varices, the information provided here will help you to understand the problem and what can be done about it.