Pediatric upper gastrointestinal bleeding in children: etiology and treatment approaches

Abstract

Objective: Upper gastrointestinal bleeding (UGB) is one of the most important and serious cause of emergency admission in childhood. The aim of the study was to evaluate the etiological factors and the treatment approaches in patients with UGB. Methods: In this retrospective study, children with UGB admitted to emergency clinics of Istanbul Health Sciences University Kanuni Sultan Suleyman Research and Training Hospital, Istanbul Bakirkoy Sadi Konuk Research and Training Hospital and Diyarbakir Children’s Hospital were evaluated between January 2014 and August 2017. Results: Of the 198 children, 14.6% had non-steroid anti-inflammatory drug (NSAID) history, and 12.6% had chronic liver disease. We detected esophagitis, esophagus varices and peptic ulcer with upper gastrointestinal endoscopic evaluation (47%, 11.1%, 18.1%, respectively). Helicobacter pylori was found in 61.6% of patients. Endoscopic therapeutic procedures (band ligation therapy, sclerotherapy, and adrenaline injection) were appied in 11.1% of patients. Eighty-four (42.4%) patients were hospitalized, and erythrocyte transfusion (ET) was ordered in 29 (14.6%) patients. Conclusion: Approximately in 20% of the pediatric patients, the source of gastrointestinal bleeding is the upper gastrointestinal system. The cause of UGB varies with age. Appropriate diagnostic and therapeutic approaches are very important for management and to reduce mortality.

Gastrointestinal tract bleeding in children with chronic cholestasis: Prevalence and risk factors in a tertiary referral hospital in Indonesia

“…reported upper gastrointestinal tract bleeding to be more common than lower gastrointestinal tract bleeding and a combination of both (63.6%, 20.7%, and 15.6%, respectively). 11 Similar findings were also reported in Iran and Turkey. 12,13 Interestingly, our univariate analysis identified several factors as statistically significant risk factors for gastrointestinal bleeding in children with biliary atresia, such as liver cirrhosis, splenomegaly, thrombocytopenia, portal hypertension, and esophageal varices.…”

“…10 On the other hand, a different study reported a notably lower incidence of esophageal varices (11.1%) among children with upper gastrointestinal bleeding. 11 The disparity in these findings could be attributed to differences in diagnostic procedures, patient selection, and variations in disease severity across the studied populations.…”