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A 14-year-old girl with a medical history of primary sclerosing cholangitis/autoimmune hepatitis overlap syndrome diagnosed at age 2, complicated by decompensated cirrhosis, underwent orthotopic liver transplantation (OLT). During OLT she… Click to show full abstract
A 14-year-old girl with a medical history of primary sclerosing cholangitis/autoimmune hepatitis overlap syndrome diagnosed at age 2, complicated by decompensated cirrhosis, underwent orthotopic liver transplantation (OLT). During OLT she underwent a standard Roux-en-Y hepaticojejunostomy in which the Roux limb was created by dividing the jejunum downstream from the ligament of Treitz. Twenty-four hours after OLT, she experienced hematochezia and acute anemia, raising concern for a luminal bleed as an adverse event of hepaticojejunostomy formation. She was subsequently referred for double-balloon enteroscopy (Video 1, available online at www.VideoGIE.org). On anterior double-balloon enteroscopy, blood was visualized in the stomach, duodenum, and entire visualized jejunum. The jejunojejunal anastomosis was patent, with healthy-appearing mucosa, and an intact staple line with
Journal Title: VideoGIE
Year Published: 2018
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