Massive Gastrointestinal Bleed as Presentation for Previously Undiagnosed Coarctation of Aorta

Neubrand, Tara; Mistry, Rakesh D.; Lefort, Roxanna

doi:10.1097/pec.0000000000000767

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Since they are rare, they are often not considered in the differential diagnosis of pediatric chest pain. Patients with congenital cardiac disease have developed aorto-esophageal fistulas but this too is rare [11][12][13][14][15][16][17][18]. To diagnose an esophageal-arterial fistula requires a high index of suspicion and either arteriography or CT is usually performed.…”

Section: Discussionmentioning

confidence: 99%

“…As seen in this patient, exsanguination can occur quickly, despite resuscitation with IV fluids and blood products. Acute GI bleeding is typically managed with antihistamines, proton pump inhibitors, and octreotide as well as fluid resuscitation [14,15,19]. Rarely is endoscopy performed emergently to tamponade the hemorrhage and thispatient was too unstable for endoscopy.…”

Section: Discussionmentioning

confidence: 99%

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Massive Pulmonary Bleed from Undiagnosed Hepatitis C Infection

Wiśniewska

2018

IPCC

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A 14 year-old previously healthy female patient presented with back pain, halitosis, and hemoccult positive stool.She was ultimately diagnosed with Takayasu’s Vasculitis and thrombo-angiitis vasculitis as well as a post-mortemdiagnosis of Hepatitis C. The two vasculitides created a pulmonary arterial-esophageal fistula with a necrotic areaand a ruptured pulmonary artery, which led to the patient’s death. Further discussion with the familyindicated thatthey were unaware of the patient’s Hepatitis C status and they denied any risk factors the patient may have had thatlead to Hepatitis C infection. Obtaining a history in pediatric patients is often limited by what the family knows anddiscloses, but when a patient presents with elevated inflammatory markers, halitosis, and hemoccult-positive stool,an esophageal fistula should be considered in one’s differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Bleed from Undiagnosed Hepatitis C Infection

Wiśniewska

2018

IPCC

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X-Ray Endovascular Occlusion in Acute Arterial Bleedings From Upper Parts of the Gastrointestinal Tract in Children

Komissarov

Борисова

Komissarov

et al. 2018

Russian Journal of Pediatric Surgery

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Acute arterial bleeding from the upper gastrointestinal tract (GIT) is a rare and life-threatening condition in children. The main method of instrumental examination in gastrointestinal hemorrhage (GIH) is fibro-esophagogastroduodenoscopy. If endoscopic diagnostics and hemostasis are ineffective, there are used other diagnostic and surgical methods of the treatment, which are associated with a high incidence of complications and high lethality. Methods of X-ray endovascular surgery, such as embolization of the arteries of the gastrointestinal tract, are life-saving and allow avoid severe traumatic surgical intervention. However, reports about the implementation of these methods in children are rare. We examined and treated 12 children with massive upper arterial GIHs. In 6 children it was managed to stop bleeding with the help of conservative and endoscopic methods of hemostasis. In 6 patients, these methods were ineffective, and they were underwent X-ray endovascular occlusion (XREO) of the blood vessels of the digestive tract. In 5 cases, embolization helped stop the bleeding after the first procedure, one child needed a repeat procedure for another source of the localization. In 6 cases, spirals were used as an embolization material, an autohemulation and microemboli were used in a one child patient. There were no complications associated with X-ray endovascular intervention. XREO is a minimally invasive and highly effective method of stopping the massive upper arterial GIH and can be performed even in children in extremely serious condition.

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Massive Gastrointestinal Bleed as Presentation for Previously Undiagnosed Coarctation of Aorta

Abstract: We discuss the case of a 15-year-old boy who presented with hypertension and massive upper GI bleed due to aortoenteric fistula formation associated with undiagnosed coarctation of the aorta. There are no other reports of a similar presentation in the literature.

Cited by 2 publications

References 18 publications

Massive Pulmonary Bleed from Undiagnosed Hepatitis C Infection

Massive Pulmonary Bleed from Undiagnosed Hepatitis C Infection

X-Ray Endovascular Occlusion in Acute Arterial Bleedings From Upper Parts of the Gastrointestinal Tract in Children

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