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Angiography in gastrointestinal bleeding in children
Insights
Arteriography correctly diagnosed gastrointestinal bleeding in 64% of pediatric patients, with higher accuracy for acute bleeds. This diagnostic tool aids in identifying causes like ulcers and vascular malformations.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Interventional Radiology
Background:
- Gastrointestinal bleeding is a significant concern in children.
- Accurate diagnosis is crucial for effective management.
- Arteriography is a potential tool for identifying bleeding sources in pediatric patients.
Purpose of the Study:
- To evaluate the diagnostic accuracy of arteriography in pediatric patients with acute or chronic gastrointestinal bleeding.
- To identify common causes of gastrointestinal bleeding in this age group.
Main Methods:
- Retrospective review of 27 pediatric patients (1 day to 16 years) undergoing arteriography for gastrointestinal bleeding.
- Exclusion of patients with known esophageal varices and portal hypertension.
- Final diagnosis confirmed through surgery, endoscopy, biopsy, laboratory data, and clinical follow-up.
Main Results:
- Arteriography provided a correct diagnosis in 64% of 25 cases, with a 36% false-negative rate.
- Diagnostic accuracy was higher in acute gastrointestinal bleeding (71% correct, 29% false-negative) compared to chronic/recurrent bleeding (55% correct, 45% false-negative).
- Common causes included gastric/duodenal ulcers, gastritis, vascular malformations, and typhlitis. Transcatheter therapy had a 50% success rate in acute bleeders.
Conclusions:
- Arteriography is a valuable diagnostic tool for pediatric gastrointestinal bleeding, particularly for acute cases.
- The study identified key causes of bleeding in children, guiding further management strategies.
- Transcatheter therapy offers a potential treatment option for selected acute bleeding events.
Abstract:
Twenty-seven children aged 1 day to 16 years studied arteriographically for acute or chronic gastrointestinal bleeding were reviewed. Children with known esophageal varices and portal hypertension were excluded. Final diagnoses were made in 25 patients by means of surgery, endoscopy, biopsy, laboratory data, and clinical follow-up. Of these 25 cases, arteriography gave a correct diagnosis in 64% and was falsely negative in 36%. In acute gastrointestinal bleeding, arteriographic diagnosis was correct in 71% and falsely negative in 29%. In chronic or recurrent gastrointestinal bleeding, arteriographic diagnosis was correct in 55% and falsely negative in 45%. The common causes of bleeding in this study were gastric and duodenal ulcers, gastritis, vascular malformations, and typhlitis. Transcatheter therapy was attempted in six acute bleeders, with success in three (50%).