Angiography in gastrointestinal bleeding in children

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.