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Upper gastrointestinal bleeding in children: an 11-year retrospective endoscopic investigation

Katherine Cleveland1, Naveed Ahmad, Phyllis Bishop

  • 1Division of Pediatric Gastroenterology, University of Mississippi Medical Center, Jackson, MS 39216, USA.

World Journal of Pediatrics : WJP
|May 11, 2012
PubMed

Insights

Improved endoscopic optics have not enhanced diagnosis for upper gastrointestinal bleeding (UGIB) in children. Timing of endoscopy and bleeding duration influence finding the source, with geographic variations in causes.

Area of Science:

  • Pediatric Gastroenterology
  • Endoscopic Diagnostics
  • Gastrointestinal Bleeding

Background:

  • Upper gastrointestinal bleeding (UGIB) presents variedly and requires esophagogastroduodenoscopy (EGD).
  • Etiology of UGIB differs globally due to regional disease prevalence.
  • Endoscopic technology has advanced, prompting re-evaluation of diagnostic efficacy.

Purpose of the Study:

  • Assess if improved endoscopic optics enhance UGIB source identification in children.
  • Investigate geographic variations in UGIB causes.
  • Analyze UGIB severity based on clinical factors.
  • Determine factors influencing the likelihood of finding a bleeding source, including symptom duration and time to endoscopy.

Main Methods:

  • Retrospective chart review of pediatric patients undergoing EGD for UGIB.
  • Data collection focused on bleeding type, etiology, and severity.

Main Results:

  • UGIB accounted for 6.5% of EGD procedures (167/2569).
  • Hematemesis was the most common presentation (73.4%); melena correlated with lower hemoglobin and higher transfusion needs.
  • A bleeding source was identified in 57.0% of cases. Source identification was less frequent with shorter bleeding history (<1 month) and delayed endoscopy (>48 hours).

Conclusions:

  • Enhanced endoscopic optics have not improved diagnostic success rates for pediatric UGIB.
  • Geographic variations in UGIB etiology are influenced by endoscopy indications, patient selection, and comorbidities.
  • Bleeding duration and time to endoscopy are critical factors for predicting successful source identification.
Abstract

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