All issues > Volume 29(8); 1986

Original Article

J Korean Pediatr Soc. 1986;29(8):845-854. Published online August 31, 1986.

Clinical Study of Upper Gastrointestinal Bleeding in Infancy and Childhood.

Soon Wook Lim¹, Ki Sup Chung¹

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

Abstract

Clinical study was performed on 76 cases of upper gastrointestinal bleeding who had been admitted to Department of Pediatrics, Yonsei University College of Medicine during the period of 6.5 years from Jaunary, 1979 to June, 1985. The results were as follows: 1) Seventy six cases with upper gastrointestinal bleeding in this study accounted for 0.32% of the total admitted patients, and sex incidence showed that males predominated in a proportion of 1,7:1. 2) Upper Gastrointestinal bleeding was most common in the age group of 1 to 6 years old as a whole. The peak incidence of esophageal varices and peptic ulcer was 1 to 6 years and 10 to 15 years old respectively. 3) The most common cause of upper gastrointestinal bleeding was peptic ulcer(36.8%). Other causes in descending order of frequency were esophageal varices (15.8%), stress ulcer (13.2%) and astritis(13.2%). 4) First manifestations of upper gastrointestinal bleeding revealed that hematemesis with melena was most common(48.7%), and next were hematemesis(30.3%) and melena(13.2%}, Six cases of peptic ulcer presented with occult blood in stool only without a history of gross bleeding. 5) Of 76 patients, 23 cases(30.2%) showed hemoglobin levels of less than 7.0 gm/dl. Bleeding was more severe in patients with esophageal varices, stress ulcers and peptic ulcers. 6) Main diagnostic aid for upper gastrointestinal bleeding was endoscopy concomitant with upper gastrointestinal barium study(31.6%), but upper gastrointestinal barium study was less successful than endoscopy for identifiying acute hemorrhagic gastitis, erosive gastrtis, and certain peptic ulcers which were superficial and small sized. 7) Majority patients(85.5%) with upper gastrointestinal bleeding received medical treatment and the remaining(14.5%) received surgical treatment. Overall mortality rate of upper gastrointestinal bleeding was 11.8%. Esophageal variceal bleeding accounted for more than half of the dead cases, and upper gastrointestinal bleeding with stress ulcer, leukemia or Reye syndrome were associated with increased mortality and poor prognosis.

Keywords :Upper gastrointestinal bleeding; Endoscopy.