| Endoscopic evaluation for gastrointestinal hemorrhage in childhood. |
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Cheol Ho Chang, Beom Soo Park, Jeong Kee Seo |
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Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea |
| 위장관 출혈을 주소로 내원한 환아의 내시경 검사소견 |
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장철호, 박범수, 서정기 |
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서울대학교 의과대학 소아과학교실 |
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Received: 19 September 1990 • Accepted: 30 November 1990 |
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| Abstract |
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The diagnosis and management of gastrointestinal tract hemorrhage in infants and children have
been changed dramatically over the past decade. Although previous reviews of this subject have
suggested that the cause of gastrointestinal tract bleeding may remain obscure in many patients,
recent experience indicates that this is now uncommon. This advance is largely a result of the
widespread and now routine application of fiberoptic endoscopy by physicians carfully trained in its
use. An endoscopic evaluation was performed on 120 patients of gastrointestinal bleeding who visited
the Pediatric department of SNUCH from June 1987 till June 1990.
The results were as follows:
1) The ratio of male to female was 1.9:1. Seventy eight patients were male, 42 patients female.
2) In upper GI bleeding, peptic ulcer showed the highest incidence (40%) and the next, esophageal
varix (28.6%). In lower GI bleeding, polyp showed the highest incidence (47.9%) and the next,
inflammatory bowel disease (31.3%).
3) The highest incidence in age was from 11 years to 15 years.
4) The types of gastrointestinal bleeding revealed hematochezia in 35 patients (29.7%), melena in
32 patients (27.1%) and hematemesis in 26 patients (22.0%).
5) According to the level of hemoglobin gastrointestinal bleeding was classified into three groups;
more than 10 gm% (59.3% of the patient), 7 gm% to 10 gm% (29.7%) and less than 7 gm% (11.0%).
6) The management of gastrointestinal hemorrhage was medical in 101 patients (85.6%) and
surgical in 17 patients (14.4%).
In conclusion, endoscopy was superior to contrast radiography in determining the site of both upper
and lower gastrointestinal tact hemorrhage. Endoscopy was also useful in treatment as well as
diagnosis particulary of lower gastrointestinal bleeding. |
| Key Words:
Gastrointestinal Bleeding, Endoscopy, Childhood |
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