Multidisciplinary treatment for acute massive upper gastrointestinal bleeding secondary to post-burn stress in a paediatric patient: a case report

作者全名："Wang, Yangping; Yang, Yong; Shu, Ziqin; Song, Huapei"

作者地址："[Wang, Yangping; Shu, Ziqin; Song, Huapei] Third Mil Med Univ, Inst Burn Res, Southwest Hosp, State Key Lab Trauma Burn & Combined Injury,Army, Chongqing, Peoples R China; [Yang, Yong] Third Mil Med Univ, Southwest Hosp, Dept Anesthesia, Army Med Univ, Chongqing, Peoples R China"

通信作者："Song, HP (通讯作者)，Third Mil Med Univ, Inst Burn Res, Southwest Hosp, State Key Lab Trauma Burn & Combined Injury,Army, Chongqing, Peoples R China."

来源：TURKISH JOURNAL OF PEDIATRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001068869200015

JCR分区：Q4

影响因子：0.8

年份：2023

卷号：65

期号：4

开始页：672

结束页：678

文献类型：Article

关键词：curling ulcer; upper gastrointestinal bleeding; gastroscopy treatment; vascular embolization

摘要："Background. Severe burns can readily induce gastric and duodenal mucosal erosions and superficial ulcers. In severe cases, haemorrhage or perforation of peptic ulcers might occur, threatening the lives of patients. At present, gastrointestinal haemorrhage after burns is treated mainly with drugs and gastrointestinal endoscopy. However, multidisciplinary treatment of gastroscopy combined with vascular embolization is rare. Case. A boy aged 3 years and 4 months was admitted to the hospital, scalded by boiling water on multiple parts of the body. On the 8th day after the injury, the patient continuously produced a large amount of tarry black stool, and the faecal occult blood test was positive. Haemostatic drug treatment was ineffective, and severe shock and disseminated intravascular coagulation (DIC) occurred. Under the guidance of a multidisciplinary team (MDT), a gastroscopy examination was performed and showed bleeding from a duodenal bulb ulcer. Due to a small intestinal lumen and thin intestinal wall, bleeding could not be controlled by gastroscopy. However, the bleeding point was clarified by gastroscopy and then gastroduodenal artery embolization was performed efficiently. No active gastrointestinal bleeding was observed after the surgery. The patient was followed for 6 months after discharge, and no gastrointestinal haemorrhage recurred. Conclusions. This is a rare case of acute massive upper gastrointestinal bleeding secondary to post-burn stress in paediatric patients. For paediatric patients who cannot be treated by endoscopy, transcatheter embolization may be safer and more effective for achieving haemostasis. Through the collaboration of the MDT, gastroscopy combined with interventional embolization was performed, which successfully stopped the massive bleeding and saved the child's life, making it worthy of clinical reference."

基金机构：　

基金资助正文：