Abstract
Background: Upper gastrointestinal bleeding (UGIB) is a relatively common and occasionally fatal emergency in children. Upper digestive endoscopy is the method of choice when establish the etiology.
Objective:: to determine the etiology of UGIB, indications for upper digestive endoscopy, the safety of the procedure in children.
Material and method: 129 children admitted in Pediatric Department, Clinical Hospital Constanta, Romania, with UGIB, undergone a number of 178 upper digestive endoscopies in a prospective study during 5 years. Endoscopy was performed under local/iv general anesthesia/iv sedation, depending on age and agreement of children and parents, after the procedure was explained.
Results: 66 boys and 63 girls aged between 9 months and 16 years (mean age 9.7 years) undergone upper digestive endoscopy for hematemesis (95 cases), melena (88 cases) and inexplicable anemia (4 cases). Endoscopy detected the site of bleeding in 118 cases (91.47%). Association of hematemesis and melena was best correlated with endoscopical findings (96.55%). The etiology revealed most frequently erosive gastritis (59 cases), esophageal varices (24 cases), duodenal ulcers (10 cases), erosive esophagitis (10 cases), erosive duodenitis (8 cases). We found rare etiology in children, such as gastric ulcer (2 cases), duodenal angiodisplasia (2 cases), gastric polyp (1 case), Mallory Weiss syndrome (1 case), gastric adenocarcinoma (1 case). We used local anesthesia (46 cases), iv anesthesia (62 cases) and iv sedation (70 cases). No complications were encountered.
Conclusion: Upper digestive endoscopy, was a safe procedure in children, visualizing recent stigmas of hemorrhage in 91,47% of cases of UGIB.
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Mihai, L., Balasa, A., Mihai, C. et al. 795 Etiology of Upper Gastrointestinal Bleeding in Children. Pediatr Res 68 (Suppl 1), 401 (2010). https://doi.org/10.1203/00006450-201011001-00795
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DOI: https://doi.org/10.1203/00006450-201011001-00795
