Atypical Manifestation of Patent Ductus Venosus in a Child: Intervening against a Paradoxical Presentation

A 6-year-old boy with massive gastrointestinal bleeding was found to have a large patent ductus venosus (PDV). Systemic symptoms of PDV (eg, hypergalactosemia and hepatic, pulmonary, and cardiac dysfunction) are frequent. However, gastrointestinal bleeding with the presence of a large portosystemic shunt is not a known complication of this anomaly. The shunt was successfully treated with embolization by using the Amplatzer vascular plug, with immediate cessation of bleeding. The authors propose that relative ischemia of the bowel, rather than portal hypertension, was the cause of the gastrointestinal bleeding in this child.