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[A rare cause of hemorrhage into the upper gastrointestinal tract in children]
1Chirurgické oddelenie NSP, Kezmarok.
Insights
A rare case of gastrointestinal bleeding in a child was caused by a thoracic aortic pseudoaneurysm. This aortic pseudoaneurysm, a complication of coarctation repair, led to fatal esophageal hemorrhage despite medical and surgical interventions.
Area of Science:
- Cardiovascular Surgery
- Pediatric Gastroenterology
- Vascular Surgery
Background:
- Hemorrhage into the gastrointestinal tract (GIT) in children presents a significant clinical challenge.
- Pseudoaneurysms, particularly those involving the aorta, are rare but life-threatening complications.
Abstract:
The authors deals in the introduction with the problem of haemorrhage into the GIT in children. He describes the case of a 12-year-old boy where originally intermittent mild haematemesis developed after 30 hours into profuse haemorrhage and called for urgent surgical intervention. Severe oesophagorrhagia of arterial origin revealed on operation was arrested by means of a Sengstaken tube and the haemorrhagic shock was checked by transfusions of 4.5 1blood. For three days the was transferred with regard to the finding and permanent treatment of the source of haemorrhage to clinical department. There, however, on the eighth day after development of haematemesis he died during thoracotomy. Haemorrhage into the stomach and gut was involved from a pseudoaneurysm of the thoracic aorta which developed in a scar after resection of its coarctation and perforated after five years into the upper oesophagus. In the conclusion the author describes the cause of development of aortodigestive fistulae, diagnostic and therapeutic difficulties of their solution and possible intervention.