Upper gastrointestinal bleeding in children and adolescents

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Bleeding
• Internal Medicine

Background:

• Upper gastrointestinal hemorrhage (UGH) is a significant concern in pediatric populations.
• Identifying common etiologies and risk factors for UGH in children is crucial for effective management.

Purpose of the Study:

• To retrospectively analyze the causes, diagnostic methods, and mortality predictors of upper gastrointestinal hemorrhage in children and adolescents.
• To determine the most frequent sources of UGH and factors associated with adverse outcomes.

Main Methods:

• Retrospective review of 68 pediatric patients (<19 years) with upper gastrointestinal hemorrhage.
• Analysis of clinical presentation, endoscopic findings, and patient outcomes.
• Statistical correlation of various factors with mortality.

Main Results:

• The most common causes of UGH were duodenal ulcers, gastric ulcers, esophagitis, gastritis, and esophageal varices.
• Endoscopy proved to be the most reliable diagnostic tool for identifying bleeding sites.
• Poor correlation was observed between clinical signs/symptoms and the bleeding source.
• Mortality was linked to low initial hematocrit/hemoglobin, high transfusion requirements, unidentified bleeding source, coagulation disorders, and coexisting life-threatening conditions.

Conclusions:

• Duodenal and gastric ulcers are primary causes of UGH in pediatric patients.
• Prompt endoscopic evaluation is essential for accurate diagnosis and management of UGH.
• Early recognition of risk factors for mortality can guide clinical interventions and improve patient outcomes.