Gastrointestinal bleeding

Kang

Pediatr Gastroenterol Hepatol Nutr

2015

PurposeThe aims of our study were to evaluate the blood urea nitrogen to creatinine ratio (BUN/Cr ratio) for distinguishing between an upper and lower gastrointestinal bleeding (GIB), and differentiating between the two most common causes of upper gastrointestinal bleeding (UGIB) presenting with melena in children.MethodsRetrospective data of patients with GIB presenting with melena were analyzed. The data from 60 cases were reviewed including demographics, laboratory findings, diagnostic modalities and results, treatments, and transfusions.ResultsAmong the 60 cases, UGIB and lower gastrointestinal bleeding (LGIB) were found in 35 cases (58.3%) and 14 cases (23.3%), respectively. The two common causes of UGIB were varices (37.1%), and peptic ulcer diseases (PUD) (31.4%). The BUN/Cr ratio of 30 or greater was higher in UGIB than LGIB (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 1.3-37.2). In UGIB, the BUN/Cr ratio of the varices group was higher than that of the PUD group (p=0.015). The OR for the BUN/Cr ratio appeared as 1.2 per unit increase in the varices group than the PUD group (95% CI, 1.03-1.3). There was no difference between the PUD group and Meckel's diverticulum group.ConclusionThe BUN/Cr ratio was not uneven in differentiating UGIB from LGIB of children with melena in our study. This suggests that BUN/Cr ratio should be interpreted carefully.

“…Melena is frequently observed in upper gastrointestinal bleeding (UGIB) above the ligament of Tretiz. It can also be seen in the small intestine and proximal colon bleeding [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Availability of Blood Urea Nitrogen/Creatinine Ratio in Gastrointestinal Bleeding with Melena in Children

Kang

Pediatr Gastroenterol Hepatol Nutr

2015

Archives of Disease in Childhood

“…Mucosal damage to the gastrointestinal tract may lead to a wide spectrum of disorders, from asymptomatic minimal lesions, to severe, potentially fatal, complications 1. Upper gastrointestinal complications (UGICs) such as bleeding are often associated with drug use, especially non-steroidal anti-inflammatory drugs (NSAIDs), oral steroids and oral anticoagulants 2…”

Section: Introductionmentioning

confidence: 99%

Drug use and upper gastrointestinal complications in children: a case-control study

Bianciotto

Chiappini

Raffaldi

et al. 2012

ObjectiveTo evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population.MethodsThis study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug.Results486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p<0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs.ConclusionsNSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.

Emergências Pediátricas: Revisões De Literatura

“…A etiologia das hemorragias gastrointestinais, tanto alta quanto baixa, estão muito relacionadas à faixa etária dos pacientes (DE CARVALHO et al, 2000;LENHARDT et al, 2016;PIMENTA et al, 2016;TORTORI, 2017). Sabendo disso e da importância do diagnóstico etiológico para o tratamento das hemorragias digestivas, seguem nos quadros abaixo a lista das principais etiologias conforme faixa etária relacionadas à HDA (Quadro 1) e à HDB (Quadro 2).…”

Section: Resultados E Discussão Etiologiaunclassified

Cetoacidose Diabética Na Infância

Chaves¹,

Bringel²,

Barroso³

2022

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