Biliary Atresia w/ Bleeding from Esophageal Varices

18mo F w/ history of biliary atresia, failed Kasai procedure now post liver transplant presents with GI bleeding.

Biliary Atresia w/ Esophageal Varices Case Outline PDF

Biliary Atresia w/ Esophageal Varices Teaching Debrief Powerpoint

Critical Actions:

1. Recognize variceal bleed risk in liver transplant patient

2. Hemostatic resuscitation with PRBC’s, platelets and FFP

3. Intubation for airway protection once vomiting blood and unstable

4. Medical management with vitamin K, protonix, octreotide, coagulopathy reversal

5. Recognize patient is immunosuppressed and will require broad spectrum antibiotics