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- Title
Successful coil embolization for life-threatening hemorrhage in childhood leukemia induction therapy.
- Authors
Hayakawa, Jun; Ueda, Takahiro; Fujiwara, Yusuke; Ozaki, Yusuke; Wakita, Satoshi; Maeda, Miho; Fukunaga, Yoshitaka
- Abstract
An 11-year-old boy was experienced severe life-threatening hemorrhage from a branch of the superior mesenteric artery (SMA) after acute lymphoblastic leukemia induction therapy. The patient had a history of attention deficit hyperactivity disorder (ADHD), diagnosed at 3 years of age. Subsequent to discontinuing his psychotropic medication, the patient's mental status deteriorated and treatment with midazolam for 3 weeks was necessary to allow the completion of the leukemia induction regimen. On day 51, although there was no indication of thrombocytopenia or a coagulation disorder, the patient began to hemorrhage suddenly from anal with resulting hypovolemic shock, and large-volume blood transfusion was initiated. Although upper and lower endoscopy failed to determine the location of the hemorrhage, angiography enabled us to determine that it was a branch of the SMA (the middle colic artery #6), and selective arterial embolization was used to arrest the bleeding. There could have been underlying causes, such as, a probable malformation or aneurysm in that area, although there was no indication before or after the event. This is a rare case of arterial hemorrhage from a branch of the SMA that occurred in a pediatric patient idiopathically during the induction therapy of leukemia.
- Publication
Pediatrics international : official journal of the Japan Pediatric Society, 2013, Vol 55, Issue 2, p248
- ISSN
1442-200X
- Publication type
Journal Article
- DOI
10.1111/j.1442-200X.2012.03682.x