Belsha D, Thomson M. Challenges of banding jejunal varices in an 8-year-old child. World J Gastrointest Endosc 2015; 7(19): 1350-1354 [PMID: 26722617 DOI: 10.4253/wjge.v7.i19.1350]
Corresponding Author of This Article
Dr. Dalia Belsha, MBChB, MRCPCH, Registrar, Department of Paediatric Gastroenterology, Sheffield Children Hospital, Weston Bank, Sheffield S10 2TH, United Kingdom. dalia.belsha@nhs.net
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Dec 25, 2015; 7(19): 1350-1354 Published online Dec 25, 2015. doi: 10.4253/wjge.v7.i19.1350
Challenges of banding jejunal varices in an 8-year-old child
Dalia Belsha, Mike Thomson
Dalia Belsha, Mike Thomson, Department of Paediatric Gastroenterology, Sheffield Children Hospital, Sheffield S10 2TH, United Kingdom
Author contributions: Belsha D wrote the case report; Thomson M contributed to reviewing the case report and the discussion around it; both authors contributed equally to the work.
Institutional review board statement: Case report has been accepted by the institutional board review to be submitted for publication.
Informed consent statement: Patient and guardian consent has been obtained for publishing the case report.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Dalia Belsha, MBChB, MRCPCH, Registrar, Department of Paediatric Gastroenterology, Sheffield Children Hospital, Weston Bank, Sheffield S10 2TH, United Kingdom. dalia.belsha@nhs.net
Telephone: +44-785-3287092 Fax: +44-114-2267956
Received: April 6, 2015 Peer-review started: April 8, 2015 First decision: May 14, 2015 Revised: June 30, 2015 Accepted: July 16, 2015 Article in press: July 17, 2015 Published online: December 25, 2015
Abstract
Endoscoic variceal ligation (EVL) by the application of bands on small bowel varices is a relatively rare procedure in gastroenterology and hepatology. There are no previously reported paediatric cases of EVL for jejunal varices. We report a case of an eight-year-old male patient with a complex surgical background leading to jejunal varices and short bowel syndrome, presenting with obscure but profound acute gastrointestinal bleeding. Wireless capsule endoscopy and double balloon enteroscopy (DBE) confirmed jejunal varices as the source of bleeding. The commercially available variceal banding devices are not long enough to be used either with DBE or with push enteroscopes. With the use of an operating gastroscope, four bands were placed successfully on the afferent and efferent ends of the leads of the 2 of the varices. Initial hemostasis was achieved with obliteration of the varices after three separate applications. This case illustrates the feasibility of achieving initial hemostasis in the pediatric population.
