Abstract
Background and Objectives: Upper GI bleeding in children is am special challenge for the medical team and parents. The causes may range from benign treatable to severe life threatening. This study has been carried out to determine causes of upper GI bleeding and to analyse demographic , endoscpic and pathologic findings.
Materials and Methods: During 2 years of study (Nov 2001 - Nov 2003), 90 children under 16 years of old, who referred to our hospital with upper GI bleeding, were admitted and after stablization of the vital signs and completion of a questionaire, underwent endoscopy and biopsy. In this study endoscopy was the preferred diagnostic modality of UGIB and pathologic studies used as complement.
Results: These 90 patient included , 45.6 female and 54.4 male, with the mean age of 7.7 years.
The most common age group was 6-10 years ( school age ) with 40% of cases. Fresh bloody vomiting was the most common presenting symptom (73% of cases).
25.6% of cases had an acute febrile illness before UGIB and 30% of them had used aspirin as an antipyretic. 17.8% of all cases had a history of aspirin ingestion which had caused erosive gastritis in 50% of them. 18.9% of cases had an underlying liver disease. The mean hospital stay was 7.4 days, The longest mean hospital stay with 15.4 days was due to esophageal varices.
Bleeding from esohageal varices, was the most common cause of anemia, thromocytopenia and prolanged PT, PTT and the most common indication for packed cell, platelete and FFP transfusion. Finally common causes of UGIB was as follows: errosive gastritis ( 33% ), gastritis ( 21%), esophageal varices (19%), peptic ulcer (13%), esophagitis and erosive esophagitis (5%).
Conclusion: Endoscopy (esophagogastroduodonoscopy) is the best and most sensitive diagnostic measure in UGIB. Bleeding esophageal varices is the most complicated and has the longest mean hospital stay. Bleeding folowing aspirin ingestion is the most preventable cause of UGIB.