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Colonic variceal bleeding in a child
Journal of Pediatric Surgery
|February 1, 1985
Insights
A child with biliary atresia experienced gastrointestinal bleeding due to colonic varices. Surgical intervention successfully resolved the bleeding, offering a potential treatment pathway for similar pediatric cases.
Area of Science:
- Pediatric Gastroenterology
- Hepatobiliary Surgery
Background:
- Biliary atresia is a severe neonatal liver disease that can lead to portal hypertension.
- Portal hypertension in children can manifest with complications such as gastrointestinal varices and bleeding.
Observation:
- A 5-year-old female patient with a history of biliary atresia presented with significant lower gastrointestinal bleeding.
- The bleeding was identified as originating from colonic varices, a rare but serious complication.
Findings:
- Initial management with vasopressin infusions provided temporary hemostasis.
- A subsequent right hemicolectomy was performed, leading to complete resolution of the gastrointestinal bleeding.
- The patient remained free of recurrent bleeding post-surgery.
Implications:
- This case highlights colonic varices as a potential cause of lower gastrointestinal bleeding in pediatric patients with biliary atresia.
- Surgical management, specifically right hemicolectomy, can be an effective definitive treatment for refractory variceal bleeding in this population.
- Further research into the optimal timing and indications for surgical intervention in pediatric portal hypertension complications is warranted.
Abstract:
A 5-year-old girl with biliary atresia is described who developed lower gastrointestinal bleeding from colonic varices. Vasopressin infusions temporarily controlled the bleeding. Following a right hemicolectomy the bleeding has not recurred.