Severe upper gastrointestinal hemorrhage in the newborn

Three infants with severe upper gastrointestinal hemorrhage with esophagogastroduodenoscopic (EGD) findings were reported. The underlying conditions of these infants included Down's syndrome, hypoplastic left heart, and diaphragmatic hernia. The precipitating factors were identified in all cases, including prenatal stress, hypoxemia, prolonged ventilatory support, and gastroesophageal reflux. The EGD findings were composed of multiple gastric ulcers and a duodenal ulcer in the first 2 cases, whereas esophagitis and gastritis were noted in the last case. These ulcers were classified as secondary peptic ulcers. All cases responded well to medical treatment, including ranitidine, sucralfate, omeprazole, cisapride, and octreotide.