Roux-en-Y loop varices in children with portal hypertension after liver transplantation: an unusual cause of "obscure" gastrointestinal bleeding.
PHALT may result from graft dysfunction, portal vein thrombosis, arterio-venous fistulas and can lead to GIB, commonly from bleeding esophageal varices. We present three children with GIB requiring multiple blood transfusions that were diagnosed with RY Loop bleeding. Routine EGD, colonoscopy, and CE failed to reveal the bleeding source. However, enteroscopy revealed large varices at the site of hepaticojejunostomy anastomosis in all. Our experience demonstrates that RY loop varices in children with PHALT are a rare and treatable cause of obscure GI bleeding.
Chu
Jaime
J
Division of Pediatric Hepatology, Mount Sinai Medical Center, New York, NY, USA.
Kerkar
Nanda
N
Miloh
Tamir A
TA
Rodriguez-Laiz
Gonzalo
G
Lewis
Blair
B
Stangl
Anondo
A
Newton
Kimberly P
KP
Iyer
Kishore
K
Arnon
Ronen
R
D000293:Adolescent; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology*; D007583:Jejunum / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects*; D014648:Varicose Veins / Q000209:etiology*