Use of Variceal Banding in Gastric Polyps Bleed-A Prototype Technique in Children

Abstract

An 8-year-old girl with a known history of Peutz-Jeghers syndrome presents a history of hematemesis to the emergency room following an episode of reaching in the early hours of the morning. Her initial evaluation showed a hemodynamically stable child but had multiple episodes of retching which were managed conservatively. She has had a past history of acute pancreatitis for which she was in pancreatic supplements and she also had a magnetic resonance imaging of the brain which was normal. She presented with a history of ileo-ileal intussusception for which she was operated 5 years ago with an end-to-end anastomosis and she has been asymptomatic since. Her annual endoscopic surveillance showed polyposis of the colon which was resected and she was under constant follow-up. She had an episode of hematemesis was an acute episode which needed evaluation with an upper gastrointestinal (GI) endoscopy which showed the presence of polyps in the gastric antrum and pylorus with Grade 2 esophageal varices. She underwent prophylactic variceal banding for her esophageal varices. Further upper GI endoscopy evaluation showed the presence of polyps in the gastric antrum, body, and pylorus. We decided to use the variceal bands to ligate the gastric polyps as an unorthodox conventional technique, as the risk of bleeding and perforation are high in polypectomy. We Find banding of gastric polyps a very safe and effective method to remove gastric polyps in the stomach.