Work

A novel approach to stabilization of bleeding gastroesophageal varices in infants

Year: 2025

Type: article

Abstract: Gastroesophageal variceal bleeding is the most serious complication of portal hypertension. The interventions available including sclerotherapy, variceal banding, and balloon tamponade, are limited by patient age. A 4-month-old with congenital cytomegalovirus, cholestasis, splenomegaly presented to the emergency room after two episodes of hematemesis. The patient required a transfusion of packed red blood cells for anemia. Upper endoscopy revealed no active bleeding, four grade 3 esophageal varices with red wale signs, and a single gastric varix. Sclerotherapy into high-risk varices was completed. Forty-eight hours later, patient developed re-bleeding. Upper endoscopy revealed bright red blood in the stomach. A large clot at the gastroesophageal junction was attributed to the gastric varix. Given the age of the patient and small size, endoscopic bleeding control interventions were limited. A foley catheter was placed in an orogastric manner for balloon tamponade. The intervention was a temporizing measure to allow for transfer to a liver transplant center.

Source: JPGN Reports

DOI: 10.1002/jpr3.70018

Authors: Sussette G. Szachowicz, Elyse Kerian, Catherine DeGeeter, Riad Rahhal

Institutions: University of Iowa, University of Iowa Stead Family Children’s Hospital

Language: English

Topic: Liver Disease and Transplantation

Subfield: Hepatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $1,900