title: Roux-en-Y loop varices in children with portal hypertension after liver transplantation: an unusual cause of "obscure" gastrointestinal bleeding.
abstract: 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.
authors.affiliation: Division of Pediatric Hepatology, Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Chu
authors.forename: Nanda
authors.initials: N
authors.lastname: Kerkar
authors.forename: Tamir A
authors.initials: TA
authors.lastname: Miloh
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Rodriguez-Laiz
authors.forename: Blair
authors.initials: B
authors.lastname: Lewis
authors.forename: Anondo
authors.initials: A
authors.lastname: Stangl
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Newton
authors.forename: Kishore
authors.initials: K
authors.lastname: Iyer
authors.forename: Ronen
authors.initials: R
authors.lastname: Arnon
mesh_terms: 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*