Survey of lower gastrointestinal bleeding in children

Abstract

Background: The presence of visible blood in stool or emesis is frightening to the child family, and at times, even to the physician. While usually patients with obvious gastrointestinal (GI) bleeding will quickly seek medical attention, those with occult intestinal blood loss are problematic. Iron deficiency anemia or guaiac positive stools may be the only evidence of intestinal bleeding. Therefore, a diagnostic and therapeutic approach to the child with suspected intestinal blood loss is critical to avoid a delay in diagnosis for the seriously ill child.
Methods: In a period of 2 years (march 2001- march 2003), we studied children with lower GI bleeding hospitalized in the Children’s Hospital, Tabriz or seen in the outpatient clinic. Data on age, sex, chief complaint, endoscopic and colonoscopic results were recorded and statistically analyzed.
Findings: There were 59 patients consisting of 20 (33.9%) females and 39 (66.1%) males. Children in preschool age formed with 31 (52.5%) cases the prevalent group. Fourty-nine (83.1%) cases presented with a complained of hematochesia and 10 cases (16.9%) had melena. Endoscopy was done in 46 patients (78%) and biopsy was obtained in 45 cases(97.8%). Polyp was the most common etiology(32.2%).
Conclusion: According to this study the majority of patients with lower GI bleeding had hematochesia as chief complaint. Colonoscopy is the best diagnostic method for determining the source of bleeding and provision of appropriate patient care is crucial in these patients.. The incidence of lesions varies depending on the age of the patient.