학술논문

Gastrointestinal bleeding in children: diagnostic approach.
Document Type
Article
Source
Italian Journal of Pediatrics. 1/23/2024, Vol. 50 Issue 1, p1-12. 12p.
Subject
*GASTROINTESTINAL hemorrhage diagnosis
*GASTROINTESTINAL hemorrhage treatment
*COLONOSCOPY
*GASTROINTESTINAL hemorrhage
*AGE distribution
*PEDIATRICS
*DIGESTIVE system endoscopic surgery
*MAGNETIC resonance imaging
*DIFFERENTIAL diagnosis
*RECTUM
*HEMATEMESIS
*COMPUTED tomography
*SYMPTOMS
*CHILDREN
ULTRASONIC imaging of the abdomen
Language
ISSN
1720-8424
Abstract
Different conditions may underlie gastrointestinal bleeding (GIB) in children. The estimated prevalence of GIB in children is 6.4%, with spontaneous resolution in approximately 80% of cases. Nonetheless, the initial approach plays a pivotal role in determining the prognosis. The priority is the stabilization of hemodynamic status, followed by a systematic diagnostic approach. GIB can originate from either upper or lower gastrointestinal tract, leading to a broad differential diagnosis in infants and children. This includes benign and self-limiting disorders, alongside serious conditions necessitating immediate treatment. We performed a nonsystematic review of the literature, in order to describe the variety of conditions responsible for GIB in pediatric patients and to outline diagnostic pathways according to patients' age, suspected site of bleeding and type of bleeding which can help pediatricians in clinical practice. Diagnostic modalities may include esophagogastroduodenoscopy and colonoscopy, abdominal ultrasonography or computed tomography and, when necessary, magnetic resonance imaging. In this review, we critically assess these procedures, emphasizing their respective advantages and limitations concerning specific clinical scenarios. [ABSTRACT FROM AUTHOR]