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Poor endoscopic findings in children with non variceal upper gastrointestinal bleeding: is biopsy necessary?

A Giannakopoulos, A Logothetis, J Panayiotou

    Hippokratia
    |February 12, 2011
    PubMed

    Insights

    Pediatric upper gastrointestinal bleeding often lacks clear endoscopic sources. However, histology reveals crucial findings like eosinophilic infiltration in infants and H. pylori-related inflammation in older children, guiding treatment.

    Area of Science:

    • Pediatric Gastroenterology
    • Gastrointestinal Endoscopy
    • Histopathology

    Background:

    • Gastrointestinal bleeding is a serious pediatric concern.
    • Investigation of upper gastrointestinal bleeding (UGIB) in children is essential.
    • Non-variceal causes of UGIB require specific diagnostic approaches.

    Purpose of the Study:

    • To describe endoscopic and histopathological findings in children with non-variceal upper gastrointestinal bleeding.
    • To correlate findings with age groups in pediatric patients.

    Main Methods:

    • Retrospective study of 181 children (1 month to 15.2 years) with non-variceal UGIB.
    • Upper GI endoscopy with histology performed between 1988-2008.
    • Patients categorized into four age groups.

    Main Results:

    • Endoscopic bleeding source identified in only 5% of patients.
    • Histology showed increased eosinophilic infiltration in infants.
    • Non-specific or H. pylori-related inflammation common in older children; peptic ulcer in 4.4%.

    Conclusions:

    • Endoscopy alone has limited diagnostic yield for UGIB source.
    • Histological examination provides vital information for diagnosing underlying pediatric GI conditions.
    • Histopathology aids in therapeutic management of pediatric UGIB.
    Abstract

    Keywords:
    childrenhematemesismelenaupper gastrointestinal bleeding

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