A Case of Massive Gastric Bleeding With Portal Hypertensive Gastropathy in Biliary Atresia

Sato Kaori, Kanamori Yutaka, Sugiyama Masahiko, Komura Makoto, Nakahara Saori

doi:10.11164/jjsps.43.6_756

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Other Title

門脈圧亢進症性胃症(portal hypertensive gastropathy)による消化管出血を合併した胆道閉鎖症術後の1患児例
症例報告門脈圧亢進性胃症(portal hypertensive gastropathy)による消化管出血を合併した胆道閉鎖症術後の1患児例
ショウレイホウコクモンミャクアツコウシンセイイショウ portal hypertensive gastropathy ニヨルショウカカンシュッケツオガッペイシタタンドウヘイサショウジュツゴノ 1 カンジレイ

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Abstract

We report a case of a 15-year-old girl who developed massive gastric bleeding caused by portal hypertensive gastropathy. She underwent Kasai's operation at 48 days of age for biliary atresia. But as she remained jaundiced, she underwent hepatic portoenterostomy again. Afterward she underwent endoscopic sclerotherapy and ligation of esophageal varices 8 times due to progressive portal hypertension. The recent esophagoscopy showed F1 esophageal varices. At the age of 15, hematemesis and hematochezia appeared on the day after she took nonsteroidal anti-inflammatory drugs (NSAIDs) for toothache and then was immediately hospitalized. Upper gastrointestinal endoscopy showed a diffuse hemorrhage in the stomach rather than lower esophagus, and portal hypertensive gastropathy was diagnosed. There are few published studies on postoperative portal hypertensive gastropathy after surgery for biliary atresia in children. It is important for pediatricians to suspect portal hypertensive gastropathy as a cause of the gastrointestinal bleeding in patients with portal hypertension. NSAIDs are one of the causes that aggravate portal hypertensive gastropathy. NSAIDs should be administered to children carefully after the operation of biliary atresia in cases complicated by portal hypertension.

Journal

Journal of the Japanese Society of Pediatric Surgeons

Journal of the Japanese Society of Pediatric Surgeons 43 (6), 756-759, 2007

The Japanese Society of Pediatric Surgeons

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