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BMC Pediatrics

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Open Access 01-12-2018 | Case report

Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report

Authors: Jiande Chen, Bin Zhang, Zhilong Yan, Huaying Zhao, Kaihua Yang, Yong Yin, Lirong Jiang

Published in: BMC Pediatrics | Issue 1/2018

Abstract

Background

The diagnosis of obscure gastrointestinal bleeding (OGIB) which is defined as bleeding of unknown origin of the small bowel by routine evaluation in childhood is a challenge.

Case presentation

Here we report a one-year-old Chinese girl who was suspected with idiopathic pulmonary haemosiderosis (IPH) and referred to our department for further diagnosis. Finally she was diagnosed with vascular malformations (VM) by exploratory laparoscopy combined with pathological examination.

Conclusions

Children OGIB could be easily misdiagnosed in the beginning, and OGIB children with active ongoing bleeding may benefit from proceeding directly to exploratory laparoscopy, followed by pathological confirmation of the diagnosis.

Raju GS, Gerson L, Das A, Lewis B. American gastroenterological association (AGA) institute technical review on obscure gastrointestinal bleeding. Gastroenterology. 2007;133(5):1697–717.CrossRef

American Gastroenterological Association medical position statement: evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000;118(1):197–201.

Romano C, Oliva S, Martellossi S, Miele E, Arrigo S, Graziani MG, Cardile S, Gaiani F, de'Angelis GL, Torroni F. Pediatric gastrointestinal bleeding: perspectives from the Italian Society of Pediatric Gastroenterology. World J Gastroenterol. 2017;23(8):1328–37.CrossRef

Kimpton JA, Bowen JC, Craigie RJ. Paediatric angiodysplasia of the jejunum: a case report and review of the literature. Scott Med J. 2012;57(4):247.CrossRef

Kim SH, Cho YH, Kim HY. Vascular malformations of the small intestine manifesting as chronic anemia: two pediatric cases managed by single-site umbilical laparoscopic surgery. Int J Surg Case Rep. 2017;31:233–6.CrossRef

Rantis PCJ, Harford FJ, Wagner RH, Henkin RE. Technetium-labelled red blood cell scintigraphy: is it useful in acute lower gastrointestinal bleeding? Int J Color Dis. 1995;10(4):210–5.CrossRef

Bloomfeld RS, Smith TP, Schneider AM, Rockey DC. Provocative angiography in patients with gastrointestinal hemorrhage of obscure origin. Am J Gastroenterol. 2000;95(10):2807–12.CrossRef

Hong SN, Kim ER, Ye BD, Jang HJ, Jeon SR, Park SJ, Im JP, Kim JH, Choi CH, Choi H, et al. Indications, diagnostic yield, and complication rate of balloon-assisted enteroscopy (BAE) during the first decade of its use in Korea. Dig Endosc. 2016;28(4):443–49.

Ma JJ, Wang Y, Xu XM, Su JW, Jiang WY, Jiang JX, Lin L, Zhang DQ, Ding J, Chen L, et al. Capsule endoscopy and single-balloon enteroscopy in small bowel diseases: competing or complementary? World J Gastroenterol. 2016;22(48):10625–30.CrossRef

10.

Oliva S, Pennazio M, Cohen SA, Aloi M, Barabino A, Hassan C, Pession A, Lima M, Frediani S, Di Nardo G. Capsule endoscopy followed by single balloon enteroscopy in children with obscure gastrointestinal bleeding: a combined approach. Dig Liver Dis : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 2015;47(2):125–30.CrossRef

11.

Lee KH, Yeung CK, Tam YH, Ng WT, Yip KF. Laparascopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatr Surg. 2000;35(9):1291–3.CrossRef

12.

Pal K, El Shafei H, Al Buainain H, Mitra DK. Successful laparoscopic treatment of hemorrhage from ileal duplication cyst in a 10-year-old Saudi boy. J Laparoendosc Adv Surg Tech Part A. 2010;20(1):99–101.CrossRef

13.

Loh DL, Munro FD. The role of laparoscopy in the management of lower gastro-intestinal bleeding. Pediatr Surg Int. 2003;19(4):266–7.CrossRef

14.

Craigie RJ, Forrest N, Nanthakumaran S, Mahomed AA. Laparoscopy in diagnosis and management of Meckel's diverticulum. J Laparoendosc Adv Surg Tech Part A. 2006;16(1):70–3.CrossRef

Title: Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report
Authors: Jiande Chen
Bin Zhang
Zhilong Yan
Huaying Zhao
Kaihua Yang
Yong Yin
Lirong Jiang
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-018-1339-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Exploratory laparoscopy combined with pathological examination in the diagnosis of obscure gastrointestinal bleeding in a child: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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