804 Upper Gastrointestinal Bleeding Between Premature and Mature Babies in Early Infancy

Abstract

Aims: Upper gastrointestinal (UGI) bleeding is not rare among pediatric patients. However, there are limited reports describing this clinical condition in young infants. This study was aimed to assess and analyze the characteristics of UGI bleeding in infants, and try to define the differences between prematurely and maturely born patients.

Methods: A retrospective review for admission up to the age of 6 months with the clinical diagnosis of UGI bleeding along with positive fetal hemoglobin confirmed by Apt-Downey test in newborns or mucosal lesions seen in the UGI tract by endoscopic examination between June 2000 and October 2007.

Results: Thirty patients were enrolled, 14 premature and 17 mature infants. More than half of the patients got the disease before 2 days of age, with more than two thirds before one month. UGI bleeding was more prevalent in premature boys (p=0.04). Most premature infants bled from their UGI tract with concomitant disease, mainly respiratory distress syndrome under airway positive pressure support. Hemorrhagic gastritis was found in 57% of the cases who received UGI endoscopy, being the most frequent. UGI bleeding stopped in 2 days on average after treatment. No recurrent UGI bleeding occurred in those patients followed for about 3 years.

Conclusions: Reason for UGI bleeding is still obscure in neonates and young infants. Premature boys seem to be more vulnerable. Conservative treatment made UGI bleeding evolute rapidly and favorably in early infancy. Both premature and mature patients recovered from UGI bleeding satisfactorily and showed no significant differences clinically.

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