Rao Krishnamurti A, Al-Hakim Ramsey, Scagnelli Thomas, Sanchez George, Munios William, Hernandez Erick, Sola Juan E, Neville Holly, Hogan Anthony, Perez Eduardo A
DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, FL.
Department of Radiology, Baptist Health South Florida, Miami, FL.
J Pediatr Surg. 2017 Oct;52(10):1699-1701. doi: 10.1016/j.jpedsurg.2017.07.002. Epub 2017 Jul 13.
BACKGROUND: Peptic ulcers in pediatric populations are uncommon and can present with upper gastrointestinal bleeding and shock on presentation. An endoscopy is done initially to identify bleeding source. However, definitive treatment is achieved with angiography. The use of coiling is effective in achieving hemorrhagic control in duodenal ulcers or gastric ulcers, particularly in adults. However, the use in pediatric populations is unknown. We present a case of peptic ulcer disease treated with a gastroduodenal artery coil in a pediatric patient that has never been reported in the literature. CASE PRESENTATION: A 15-year-old male with a five-year history of peptic ulcer disease was admitted with an upper gastrointestinal bleed. Angiographic imaging was done to isolate and locate the bleeding, and coil embolization of the gastroduodenal artery was performed. Coils eroded into intestinal lumen but bleeding was controlled. CONCLUSION: Peptic ulcers in pediatric populations are rare and complex in nature. Besides aggressive resuscitation and endoscopy, other methods to control bleeding such as coil embolization can be performed. Further investigations are needed to understand long-term effects of coil embolization in pediatric peptic ulcer patients. LEVEL OF EVIDENCE: 5/Case Report/.
背景:小儿消化性溃疡并不常见,发病时可出现上消化道出血和休克。最初需进行内镜检查以确定出血源。然而,血管造影术可实现确定性治疗。使用弹簧圈栓塞术在控制十二指肠溃疡或胃溃疡出血方面有效,尤其在成人中。但在小儿群体中的应用情况尚不清楚。我们报告一例小儿消化性溃疡疾病患者,采用胃十二指肠动脉弹簧圈栓塞术治疗,此病例在文献中未见报道。 病例介绍:一名有5年消化性溃疡病史的15岁男性因上消化道出血入院。进行血管造影成像以分离并定位出血点,随后对胃十二指肠动脉进行弹簧圈栓塞。弹簧圈侵蚀至肠腔,但出血得到控制。 结论:小儿消化性溃疡罕见且性质复杂。除积极复苏和内镜检查外,还可采用如弹簧圈栓塞等其他控制出血的方法。需要进一步研究以了解弹簧圈栓塞术对小儿消化性溃疡患者的长期影响。 证据级别:5/病例报告/
J Pediatr Surg. 2017-10
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