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Upper gastrointestinal endoscopy in children with upper gastrointestinal bleeding
I-Fei Huang1, Tzee-Chung Wu, Ke-Sheng Wang
1Department of Pediatrics, Kaohsiung Yeterans General Hospital, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|August 12, 2003
Summary
Upper gastrointestinal (UGI) endoscopy is effective for diagnosing and treating UGI bleeding in children. Superficial gastric mucosal lesions were the most frequent finding, and Helicobacter pylori is linked to duodenal ulcers in some cases.
Area of Science:
- Pediatric Gastroenterology
- Endoscopy
- Infectious Diseases
Background:
- Upper gastrointestinal bleeding (UGIB) is a significant concern in pediatric patients.
- Understanding the endoscopic findings and etiological factors is crucial for effective management.
Purpose of the Study:
- To evaluate clinical presentations and endoscopic features of UGIB in children.
- To determine the role of Helicobacter pylori in pediatric UGIB.
Main Methods:
- Retrospective review of 112 children with UGIB undergoing upper gastrointestinal (UGI) endoscopy.
- Exclusion of cases due to caustic agents or foreign bodies.
- Analysis of clinical manifestations, underlying diseases, endoscopic findings, and rapid urease tests for H. pylori.
Main Results:
- Hematemesis was the most common symptom (68.8%).
- Superficial gastric mucosal lesions (SGML) were the most frequent endoscopic finding (44.6%).
- Helicobacter pylori was significantly associated with primary duodenal ulcers (DU), especially in children without underlying diseases.
Conclusions:
- UGI endoscopy is a valuable diagnostic and therapeutic tool for pediatric UGIB.
- A significant proportion of children had underlying conditions or a history of acute febrile illness.
- Helicobacter pylori plays a role in a subset of pediatric UGIB, particularly those with primary DU.