Challenges of banding jejunal varices in an 8-year-old child

• 作者: Dalia Belsha Mike Thomson
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Endoscopic variceal LIGATION Endoscopichemostasis PEDIATRICS GASTROINTESTINAL HEMORRHAGE VARICES Variceal BANDING
• 年，卷（期）: 2015,（19）
• 页码范围: 1350-1354
• 页数: 5页
• 分类号: R

摘要

Endoscoic variceal ligation （EVL） by the applicationof bands on small bowel varices is a relatively rareprocedure in gastroenterology and hepatology. Thereare no previously reported paediatric cases of EVLfor jejunal varices. We report a case of an eight-yearoldmale patient with a complex surgical backgroundleading to jejunal varices and short bowel syndrome,presenting with obscure but profound acute gastrointestinalbleeding. Wireless capsule endoscopy and double balloonenteroscopy （DBE） confirmed jejunal varices as thesource of bleeding. The commercially available varicealbanding devices are not long enough to be used eitherwith DBE or with push enteroscopes. With the useof an operating gastroscope, four bands were placedsuccessfully on the afferent and efferent ends of theleads of the 2 of the varices. Initial hemostasis wasachieved with obliteration of the varices after threeseparate applications. This case illustrates the feasibilityof achieving initial hemostasis in the pediatric population.