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Case Reports in Pediatrics
Volume 2012, Article ID 964845, 5 pages
http://dx.doi.org/10.1155/2012/964845
Case Report

Superior Mesenteric Vein Occlusion Causing Severe Gastrointestinal Haemorrhage in Two Paediatric Cases

1Department of Paediatric Gastroenterology, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
2Department of Paediatric Radiology, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
3Department of Paediatric General Surgery, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK

Received 29 June 2012; Accepted 1 October 2012

Academic Editors: J. B. Amodio, J. Hruda, A. C. Lee, K.-H. Lue, C. Modesto, and A. Spalice

Copyright © 2012 Anna L. Fox et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reports about superior mesenteric vein thrombosis in childhood are very rare and have not been associated with gastrointestinal bleeding. We describe two cases of severe bleeding from the upper and lower gastrointestinal tract in children who had undergone complex abdominal surgery at considerable time before. The first child had a tracheoesophageal fistula, corrected by division, gastrostomy insertion, and repair of duodenal rupture. The child presented with severe bleeding from the gastrostomy site and was diagnosed with a thrombosis of the proximal superior mesenteric vein. The second child had a gastroschisis and duodenal atresia, and required duodenoplasty, gastrostomy insertion, hemicolectomy, and adhesiolysis. The child presented with intermittent severe lower gastrointestinal bleeding, resulting from collateral vessels at location of the surgical connections. He was diagnosed with a thrombosis of the superior mesenteric vein. In both children, the extensive previous surgery and anastomosis were considered the cause of the mesenteric thrombosis. CT angiography confirmed the diagnosis in both cases, in addition to characteristic findings on endoscopy. Paediatricians should suspect this condition in children with severe gastrointestinal bleeding, particularly in children with previous, complex abdominal surgery.