Gastroduodenal artery coiling to curb upper gastrointestinal bleeding

J Pediatr Surg. 2017 Oct;52(10):1699-1701. doi: 10.1016/j.jpedsurg.2017.07.002. Epub 2017 Jul 13.

Abstract

Background: Peptic ulcers in pediatric populations are uncommon and can present with upper gastrointestinal bleeding and shock on presentation. An endoscopy is done initially to identify bleeding source. However, definitive treatment is achieved with angiography. The use of coiling is effective in achieving hemorrhagic control in duodenal ulcers or gastric ulcers, particularly in adults. However, the use in pediatric populations is unknown. We present a case of peptic ulcer disease treated with a gastroduodenal artery coil in a pediatric patient that has never been reported in the literature.

Case presentation: A 15-year-old male with a five-year history of peptic ulcer disease was admitted with an upper gastrointestinal bleed. Angiographic imaging was done to isolate and locate the bleeding, and coil embolization of the gastroduodenal artery was performed. Coils eroded into intestinal lumen but bleeding was controlled.

Conclusion: Peptic ulcers in pediatric populations are rare and complex in nature. Besides aggressive resuscitation and endoscopy, other methods to control bleeding such as coil embolization can be performed. Further investigations are needed to understand long-term effects of coil embolization in pediatric peptic ulcer patients.

Level of evidence: 5/Case Report/.

Keywords: Angiographic; Coils; Gastroduodenal artery; Pediatric surgery; Peptic ulcer disease.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Angiography / methods
  • Duodenum / blood supply
  • Embolization, Therapeutic / methods*
  • Gastrointestinal Hemorrhage / therapy
  • Hemostasis, Endoscopic / methods*
  • Hepatic Artery / surgery*
  • Humans
  • Male
  • Peptic Ulcer Hemorrhage / therapy*
  • Treatment Outcome