Adv Pediatr Surg.  2021 Jun;27(1):27-31. 10.13029/aps.2021.27.1.27.

Successful Multiteam Approach for Massive Jejunoileal Bleeding 10 Years after Gastrectomy for Spontaneous Gastric Perforation in Neonate: a Case Report

• Jeong JH
• Kim IS
• Kim HS
• Kim WD
• Hah JO

• KMID: 2525529
• DOI: http://doi.org/10.13029/aps.2021.27.1.27

Abstract

Obscure gastrointestinal bleeding (OGIB) from the small bowel is difficult to diagnose, especially in children. We report a 10-year-old boy who presented sudden onset of severe anemia with massive OGIB who had a history of total gastrectomy in the neonatal period. Abdominal computed tomography, esophagogastroduodenoscopy, colonoscopy, Meckel's diverticulum scan, superior mesenteric arteriography, and celiac arteriography found no definite bleeding focus. Finally, capsule endoscopy revealed numerous vascular ectasias and multiple bleeding foci at jejunoileal region. With laparotomy and manual milking up of the small bowel by the surgeon, intraoperative endoscopy with argon plasma coagulations and hemo-clippings were done by the gastroenterologist, successfully. Intraoperative endoscopic management seems to be the treatment of choice for preventing massive unnecessary bowel resection. Here, we report a patient with OGIB, 10 years after gastrectomy for spontaneous rupture of stomach in the neonate period, which was diagnosed and managed successfully with a multiteam approach.

Keyword

Melena; Gastrointestinal endoscopy; Capsule endoscopy; Gastrointestinal hemorrhage; Surgical endoscopy