Hepatic veno-occlusive disease followed by esophageal varix rupture after hematopoietic stem cell transplantation in a 4-year-old boy with stage 4 neuroblastoma.

Hepatic veno-occlusive disease (HVOD) is one of the major potential complications associated with high-dose chemotherapy with stem cell transplantation in children. However, esophageal varix rupture after HVOD has, to our knowledge, never been reported before. Here we report a case of a 4-year-old boy with stage 4 neuroblastoma with potentially fatal HVOD followed by esophageal varix rupture and massive intestinal bleeding after high-dose chemotherapy with autologous peripheral blood stem cell transplantation. We successfully treated him by endoscopic variceal ligation and administration of somatostatin analog.