Upper Gastrointestinal Bleeding in Pediatric Populations
Summary
Upper gastrointestinal bleeding (UGIB) in children encompasses haemorrhage originating proximal to the ligament of Treitz. Presentations range from mild occult blood loss to life-threatening haematemesis and melaena, with an incidence of approximately 1–6 per 100 000 persons annually. Aetiologies vary by age and geography, including mucosal erosions, peptic ulcer disease, vascular malformations and variceal bleeding secondary to portal hypertension. The clinical approach prioritises rapid assessment of airway, breathing and circulation, with attention to signs of haemodynamic instability. Initial management entails fluid resuscitation, blood product support and proton-pump inhibitor therapy. Diagnostic endoscopy, chiefly oesophagogastroduodenoscopy (EGD), is the gold standard for lesion localisation and therapeutic intervention. Recent advances in paediatric endoscopic haemostasis and risk stratification have improved outcomes, yet challenges persist in resource-limited settings and in distinguishing self-limiting conditions from those requiring invasive management. A multidisciplinary team, comprising paediatric gastroenterologists, surgeons and intensivists, is essential to optimise care pathways, reduce morbidity and guide preventive strategies.
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Upper Gastrointestinal Bleeding in Pediatric Populations publication trend
The graph below shows the total number of articles in upper gastrointestinal bleeding in pediatric populations across all publications each year (not limited to Nature Index journals).
Technical terms
Haematemesis: Vomiting of blood indicating upper gastrointestinal bleeding.
Melena: Black, tarry stools resulting from digested blood in the gastrointestinal tract.
Esophagogastroduodenoscopy (EGD): Endoscopic examination of the oesophagus, stomach and duodenum for diagnosis and treatment of upper gastrointestinal lesions.
Helicobacter pylori: Spiral bacterium implicated in peptic ulcer disease and gastritis.
Non-steroidal anti-inflammatory drug (NSAID): Medication class that can cause mucosal injury and precipitate gastrointestinal bleeding.
References
- Trends in Upper Gastrointestinal Bleeding in Children: The Impact of Helicobacter pylori Infection and Non-Steroidal Anti-Inflammatory Drug Use. Antibiotics (2024).
- Gastrointestinal bleeding in children: diagnostic approach. Italian Journal of Pediatrics (2024).
- Practical Aspects of Upper Gastrointestinal Bleeding in Children. Journal of Clinical Medicine (2023).
- Diagnostic yield of esophagogastroduodenoscopy in upper gastrointestinal bleeding in pediatrics: a cross-sectional study at a tertiary center. Egyptian Pediatric Association Gazette (2023).
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