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Published on: April 26, 2019
[Analysis of 136 children with gastrointestinal hemorrhage]
1Department of Pediatrics, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Insights
Pediatric gastrointestinal bleeding often stems from ulcers in older children and congenital abnormalities in infants. Early endoscopy within 48 hours improves diagnosis of upper gastrointestinal hemorrhage.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Endoscopy
Context:
- Gastrointestinal hemorrhage is a significant concern in pediatric patients.
- Accurate diagnosis is crucial for effective treatment and management.
Purpose:
- To investigate the causes and distribution of pediatric gastrointestinal bleeding.
- To identify reasons for misdiagnosis before endoscopic examination.
- To determine the optimal timing for gastrointestinal endoscopy.
Summary:
- A study of 136 children with suspected upper gastrointestinal hemorrhage (UGH) using endoscopy revealed common causes like gastric and duodenal ulcers in older children, and congenital abnormalities in infants.
- Misdiagnoses included ascariasis and enterospasm.
- The pathogeny of 22 cases remained unclear.
- Endoscopy within 48 hours of the latest bleed is recommended for the highest diagnostic yield.
Impact:
- Highlights common etiologies of pediatric gastrointestinal bleeding.
- Underscores the importance of timely endoscopic evaluation.
- Provides insights into diagnostic challenges and misdiagnosis in pediatric GI bleeding.
Objective:
To investigate the pathogeny of children with gastrointestinal hemorrhage, pathogeny distribution and the cause of misdiagnosis before gastrointestinal endoscopy check-up.
Methods:
We detected 136 children suspected upper gastrointestinal hemorrhage (UGH) by gastrointestinal endoscopy and among them a few cases were diagnosed by celiotomy.
Results:
One hundred and three cases of UGH, 7 cases of small intestine bleeding, and 4 cases of gulping blood syndrome were diagnosed; but the pathogeny of the other 22 cases was not clear.
Conclusion:
Gastric ulcer and duodenal ulcer are the common causes of gastrointestinal hemorrhage of elder children and inheriting alimentary canal abnormality leads to gastrointestinal hemorrhage of infants. Some children with bellyache were misdiagnosed as ascariasis or enterospasm. The endoscopy examination should carry on within 48 hours after the latest bleeding to reach the highest positive rate.
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