A 14-year-old boy, a known case of perinatal hypoxic cerebral palsy, presented to paediatric emergency with acute melaena and blood staining around feeding gastrostomy site. Physical examination revealed pallor, but no signs of distress with an unremarkable abdominal examination. Routine blood tests revealed normochromic. Abdominal ultrasound scan and Meckel’s scan were unremarkable. The patient underwent examination under anaesthesia of the perianal area and joint upper and lower gastrointestinal endoscopy. Streak-like gastritis with no signs of active bleeding lesions were noted and patchy areas of colitis involving the descending and sigmoid colon and the rectum. All clinical findings and evidence-based diagnosis matched gastric antral vascular ectasia. He was successfully managed conservatively with elemental hydrolysed feeding formula.
- childhood nutrition
- GI bleeding
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Contributors MP was involved in the case summary, background information, case presentation, differential diagnosis, treatment, follow-up and a small part of the discussion. SE was involved in the write-up of background information, case presentation, investigations, differential diagnosis, treatment, follow-up and a small part of the discussion. MS was involved in all aspects, constantly adjusting all sections of the paper as well as contributing heavily towards the discussion aspect. MP and SE were both involved in all sections and liaised regularly with MS.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer-reviewed.
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