Serious intestinal bleeding from vascular ectasia secondary to portal thrombosis after living-related liver transplantation in a child.
Serious intestinal bleeding from vascular ectasia secondary to extrahepatic portal thrombosis is much less frequent than variceal bleeding, and its treatment is not clearly defined. We describe a 4-year-old girl with repeated intestinal bleeding from vascular ectasia, without any varix, with late extrahepatic portal vein thrombosis (PVT) and late hepatic artery thrombosis (HAT) after living-related liver transplantation. The bleeding stopped after simple splenectomy. She has presented neither bleeding nor any serious complications related to splenectomy for 1 year to date. We think uncontrollable hemorrhage from gastrointestinal vascular ectasia secondary to extrahepatic portal thrombosis in a pediatric patient can and should be treated by simple splenectomy, because patients with this complication usually have a normally functioning liver. However, it is not clear whether this procedure is effective for variceal bleeding.
Usuda
Masahiro
M
Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
Fujimori
Keisei
K
Koyamada
Nozomi
N
Fukumori
Tatsuya
T
Sekiguchi
Satoshi
S
Kawagishi
Naoki
N
Akamatsu
Yorihiro
Y
Tsukamoto
Shigeki
S
Enomoto
Yoshitaka
Y
Ohkouchi
Nobuhiro
N
Satomi
Susumu
S
D002675:Child, Preschool; D003097:Collateral Circulation; D004108:Dilatation, Pathologic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006499:Hepatic Artery / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D011169:Portal Vein / Q000473:pathology*; D011183:Postoperative Complications; D013927:Thrombosis / Q000150:complications*