All issues > Volume 34(4); 1991

Original Article

J Korean Pediatr Soc. 1991;34(4):515-524. Published online April 30, 1991.

Endoscopic evaluation for gastrointestinal hemorrhage in childhood.

Cheol Ho Chang¹, Beom Soo Park¹, Jeong Kee Seo¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea

Received: September 19, 1990;  Accepted: November 30, 1990.

Abstract

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.

Keywords :Gastrointestinal Bleeding;Endoscopy;Childhood