Steg Saban Or, Pope Elena, Chavhan Govind B, Carcao Manuel, Talarico Susanna, Ling Simon C
Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON.
Division of Pediatric Dermatology, The Hospital for Sick Children, Toronto, ON.
ACG Case Rep J. 2025 Jun 27;12(7):e01755. doi: 10.14309/crj.0000000000001755. eCollection 2025 Jul.
We present the case of a 3-week-old girl with multiple cutaneous vascular lesions, melena, hematemesis, severe anemia (hemoglobin 4.4 g/dL), and thrombocytopenia (72 × 10/µL), with clinical features consistent with multifocal lymphangioendotheliomatosis with thrombocytopenia (MLT). Upper gastrointestinal endoscopy revealed numerous actively bleeding angiomatous lesions, measuring 1-3 mm in diameter. Homeostasis was successfully achieved using argon plasma coagulation (APC). To our knowledge, this is among the few reports describing the effective use of APC in managing life-threatening gastric hemorrhage in an infant with MLT. While gastrointestinal perforation has been previously reported as a complication of endoscopic therapy in this context, our findings suggest that APC may be a viable option for refractory bleeding, provided that surgical support is immediately accessible.
我们报告了一名3周大的女婴病例，她有多处皮肤血管病变、黑便、呕血、严重贫血（血红蛋白4.4 g/dL）和血小板减少（72×10/µL），临床特征符合伴血小板减少的多灶性淋巴管内皮瘤病（MLT）。上消化道内镜检查发现大量直径为1 - 3毫米的活动性出血性血管瘤病变。使用氩离子凝固术（APC）成功实现了止血。据我们所知，这是少数描述APC有效用于治疗MLT婴儿危及生命的胃出血的报告之一。虽然在此背景下内镜治疗的并发症此前曾报道有胃肠道穿孔，但我们的研究结果表明，只要能立即获得手术支持，APC可能是治疗难治性出血的可行选择。
