title: Serious intestinal bleeding from vascular ectasia secondary to portal thrombosis after living-related liver transplantation in a child.
abstract: 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.
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Usuda
authors.forename: Keisei
authors.initials: K
authors.lastname: Fujimori
authors.forename: Nozomi
authors.initials: N
authors.lastname: Koyamada
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fukumori
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sekiguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.forename: Yorihiro
authors.initials: Y
authors.lastname: Akamatsu
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tsukamoto
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkouchi
authors.forename: Susumu
authors.initials: S
authors.lastname: Satomi
mesh_terms: 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*