Gastrointestinal endoscopy clinics of North America
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Laparoscopy is an invaluable technique for the evaluation of ascites in subgroups of patients with ascites. Indications for laparoscopic examination include determination of the causes of ascites when routine tests fail to disclose the source, evaluation for the presence of multiple causes of ascites formation, or histopathologic verification of malignancy within the peritoneal cavity. Several reported series have illustrated the efficacy of laparoscopy for the diagnosis of peritoneal carcinomatosis, tuberculous peritonitis, or unsuspected cirrhosis, securing its role in the management of selected patients with ascites.
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Endoscopy often is required in the management of patients with chronic liver disease. Endoscopy in this pediatric population is a safe and effective diagnostic and therapeutic modality for the appropriate clinical situation. ⋯ Advances in technical innovations will expand the currently offered diagnostic and therapeutic options for management of pediatric with portal hypertension. This article reviews specific considerations for endoscopy in this demanding patient population.