Severe gastrointestinal hemorrhage from an eroding jejuno-jejunal fistula

We present the case of an 11-year old boy with mosaic trisomy 13 and an end ileostomy (for gut dysmotility) who presented with a catastrophic gastrointestinal haemorrhage during a prolonged Paediatric Intensive Care (PICU) stay recovering from an episode of presumed sepsis. A normal upper GI endoscopy was followed by a laparoscopy which revealed a small bowel adhesion to the anterior abdominal wall which had facilitated the creation of a jejuno-jejunal fistula that had eroded through a mesenteric artery. The child recovered well after a limited laparotomy and segmental small bowel resection.This case highlights an extremely unusual cause of gastrointestinal bleeding in a child and emphasises the role of Laparoscopy in the comprehensive assessment of this presentation.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research