Chu Jaime, Kerkar Nanda, Miloh Tamir A, Rodriguez-Laiz Gonzalo, Lewis Blair, Stangl Anondo, Newton Kimberly P, Iyer Kishore, Arnon Ronen
Division of Pediatric Hepatology, Mount Sinai Medical Center, New York, NY, USA.
Pediatr Transplant. 2011 Dec;15(8):E156-61. doi: 10.1111/j.1399-3046.2010.01351.x. Epub 2010 Jul 1.
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.
门静脉高压性胃病（PHALT）可能由移植功能障碍、门静脉血栓形成、动静脉瘘引起，并可导致胃肠道出血（GIB），通常是由食管静脉曲张破裂出血所致。我们报告了三名患有GIB且需要多次输血的儿童，他们被诊断为RY袢出血。常规的上消化道内镜检查（EGD）、结肠镜检查和小肠造影（CE）均未能发现出血源。然而，小肠镜检查发现所有患儿的肝空肠吻合部位均有大量静脉曲张。我们的经验表明，PHALT患儿的RY袢静脉曲张是隐匿性胃肠道出血的一种罕见但可治疗的原因。
