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Advances in standardized diagnosis and management of pediatric gastrointestinal bleeding
Qian-Cheng Xu1, Zi-Yu Liu2, Fei Gao2
1Department of Gastroenterology and Pediatric Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou 310052, China.
Insights
Pediatric gastrointestinal bleeding (GIB) requires tailored management. Early assessment, risk identification, and timely endoscopic treatment are crucial for improving outcomes and reducing mortality in children with GIB.
Area of Science:
- Pediatric Gastroenterology
- Clinical Management
- Endoscopic Interventions
Background:
- Gastrointestinal bleeding (GIB) is common in children, with varied causes across age groups.
- Current pediatric GIB management often relies on adult data, overlooking key differences.
- Pediatric GIB poses life-threatening risks, necessitating specialized approaches.
Purpose of the Study:
- To synthesize current evidence for optimizing pediatric GIB management.
- To highlight the need for standardized protocols distinct from adult guidelines.
- To improve diagnostic and therapeutic strategies for pediatric GIB.
Main Methods:
- Systematic literature review of PubMed, Embase, and Chinese Journal Full-text Database up to February 2025.
- Inclusion of search terms: "pediatric", "upper gastrointestinal bleeding", "peptic ulcer", "lower gastrointestinal bleeding", "endoscopic diagnosis and treatment".
- Synthesis of evidence to inform standardized pediatric GIB management.
Main Results:
- Early, comprehensive assessment and high-risk factor identification are vital for pediatric GIB outcomes.
- Timely endoscopic examination and proactive treatment significantly impact results.
- Optimized diagnosis, treatment processes, and multidisciplinary consultation improve pediatric GIB management.
Conclusions:
- Maintaining hemodynamic stability and vital signs is paramount in pediatric GIB.
- Early etiological diagnosis and prompt, effective hemostasis are key to successful treatment.
- Effective management reduces complications and mortality in pediatric GIB cases.
Background:
Gastrointestinal bleeding (GIB) is a prevalent clinical condition in pediatric populations that is characterized by etiological heterogeneity across age groups with potentially life-threatening risks in critical cases. Current management strategies predominantly extrapolate from adult-based studies and guidelines. This is despite substantial differences between pediatric and adult patients regarding bleeding etiology, risk stratification, peri-endoscopic pharmacotherapy, hemostatic technique selection, and salvage interventions after initial hemostasis failure.
Data Sources:
A systematic literature review was conducted via PubMed, Embase, and the Chinese Journal Full-text Database up to February 2025. Search terms included "pediatric", "upper gastrointestinal bleeding", "peptic ulcer", "lower gastrointestinal bleeding" and "endoscopic diagnosis and treatment". This review synthesizes current evidence to optimize standardized management of pediatric GIB.
Results:
Early and comprehensive assessment of children with GIB, early identification of high-risk factors for GIB, timely use of endoscopic examination, proactive treatment, optimization of diagnosis and treatment processes, and multidisciplinary consultation have important impacts on the outcome of GIB in children.
Conclusions:
Ensuring hemodynamic stability and vital signs in children with GIB, early identification of disease cause and timely, and effective hemostatic treatment are key to improving treatment success, reducing complications and lowering mortality.
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