Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jul 16, 2017; 9(7): 341-345
Published online Jul 16, 2017. doi: 10.4253/wjge.v9.i7.341
Management of hyperplastic gastric polyp following upper gastrointestinal bleeding in infant with Menkes’ disease
Dalia Belsha, Priya Narula, Arun Urs, Mike Thomson
Dalia Belsha, Priya Narula, Arun Urs, Mike Thomson, Centre of Paediatric Gastroenterology, Sheffield Children’s Hospital, Sheffield S10 2TH, United Kingdom
Author contributions: Thomson M designed the report and provided the images; Belsha D collected patient data, performed the literature search and wrote the paper; Narula P, Urs A and Thomson M revised and edited the manuscript.
Institutional review board statement: We confirm that the case was reviewed and approved by the clinical effectiveness and audit committee at the Sheffield’s Children to be submitted for publications.
Informed consent statement: We confirm that the patient’s parents were provided with informed consent and they both agreed for the case report to be published and agreed on the use of the images for publication.
Conflict-of-interest statement: There is 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: Mike Thomson, FRCPCH, MD, Professor, Centre of Paediatric Gastroenterology, Sheffield Children’s Hospital, Western Bank, Sheffield S10 2TH, United Kingdom. mike.thomson@sch.nhs.uk
Telephone: +44-11-42717673 Fax: +44-11-42717242
Received: November 11, 2016
Peer-review started: November 13, 2016
First decision: March 8, 2017
Revised: April 5, 2017
Accepted: April 18, 2017
Article in press: April 19, 2017
Published online: July 16, 2017
Abstract

We report a case of an infant with Menkes’ disease (MD) presented at the age of five months, with coffee ground vomiting, melaena with a significant drop of haemoglobin. Urgent endoscopic assessment revealed a friable bleeding trans-pyloric multi-lobulated sessile polyp. Due to further significant upper gastrointestinal bleeding, polypectomy occurred. Endoscopic mucosal resection was performed with a grasp-and-snare technique using a dual channel operating gastroscope. Haemostasis was achieved by application of argon plasma coagulation where required. No perforation occurred. Repeated debridement was required 6 wk after which the growth was excised completely with no further blood transfusion required after that procedure. Histological examination confirmed ulcerated and inflamed hyperplastic polyp. We discuss our endoscopic technique and discuss the reported gastrointestinal manifestation of MD in the literature.

Keywords: Menkes’ disease, Gastrointestinal bleeding, Grasp and snare technique, Polypectomy, Gastric polyp

Core tip: Infant with Menkes’ disease can present with a potentially life threatening bleeding from hyperplastic gastric polyp. Removing hyperplastic polyp in those infants using grasp and snare technique is feasible and can avoid unnecessary surgical excision in those children.