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Gastrointestinal Bleeding in Children: Current Management, Controversies, and Advances.

Inna Novak1, Lee M Bass2

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Summary

This review covers diagnosing and treating upper gastrointestinal bleeding (UGIB) in children. Key treatments include patient stabilization and endoscopic therapies for severe bleeding cases.

Keywords:
EpinephrineEsophageal varicesHemoclipsPediatric endoscopyPortal hypertensionTransfusionUlcerUpper gastrointestinal bleeding

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Area of Science:

  • Pediatric Gastroenterology
  • Gastrointestinal Hemorrhage

Background:

  • Upper gastrointestinal bleeding (UGIB) in children presents with diverse etiologies and age-dependent prevalence.
  • Clinical manifestations include hematemesis and melena, necessitating prompt medical intervention.

Purpose of the Study:

  • To review the diagnosis and management of variceal and non-variceal UGIB in pediatric patients.
  • To highlight recent advancements in treating severe UGIB in children.

Main Methods:

  • Literature review focusing on diagnostic modalities and therapeutic strategies for pediatric UGIB.
  • Emphasis on endoscopic interventions and their combinations.

Main Results:

  • Initial management involves airway protection, fluid resuscitation, and a hemoglobin threshold of 7 g/L for transfusion.
  • Endoscopic treatment commonly employs epinephrine injection combined with cautery, hemoclips, or hemospray.

Conclusions:

  • Effective management of pediatric UGIB requires prompt stabilization and tailored endoscopic therapies.
  • Advances in endoscopic techniques offer improved outcomes for severe bleeding cases.