# A novel approach to stabilization of bleeding gastroesophageal varices in infants

## TL;DR

This paper describes a case where a novel method using a foley catheter was used to control bleeding in an infant with gastroesophageal varices.

## Contribution

The use of a foley catheter for balloon tamponade in a very young infant with limited endoscopic options is presented as a novel approach.

## Key findings

- A 4-month-old infant with congenital cytomegalovirus and portal hypertension experienced re-bleeding after initial sclerotherapy.
- A foley catheter was used as a temporizing measure for balloon tamponade due to the patient's age and size limitations.
- The intervention allowed for safe transfer to a liver transplant center.

## Abstract

Gastroesophageal variceal bleeding is the most serious complication of portal hypertension. The interventions available including sclerotherapy, variceal banding, and balloon tamponade, are limited by patient age. A 4‐month‐old with congenital cytomegalovirus, cholestasis, splenomegaly presented to the emergency room after two episodes of hematemesis. The patient required a transfusion of packed red blood cells for anemia. Upper endoscopy revealed no active bleeding, four grade 3 esophageal varices with red wale signs, and a single gastric varix. Sclerotherapy into high‐risk varices was completed. Forty‐eight hours later, patient developed re‐bleeding. Upper endoscopy revealed bright red blood in the stomach. A large clot at the gastroesophageal junction was attributed to the gastric varix. Given the age of the patient and small size, endoscopic bleeding control interventions were limited. A foley catheter was placed in an orogastric manner for balloon tamponade. The intervention was a temporizing measure to allow for transfer to a liver transplant center.