Upper gastrointestinal bleeding in children in Southern Iran

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• 作者：Seyed Mohsen Dehghani (1)
  Mahmood Haghighat (1)
  Mohammad Hadi Imanieh (1)
  Mahmood Reza Tabebordbar (2)
  
• 关键词：Upper gastrointestinal bleeding ; Children ; Etiology ; Empiric therapy
• 刊名：The Indian Journal of Pediatrics
• 出版年：2009
• 出版时间：June 2009
• 年：2009
• 卷：76
• 期：6
• 页码：635-638
• 全文大小：226KB
• 参考文献：1. Rayhorn N, Thrall C, Silber G. A review of the causes of upper gastrointestinal tract bleeding in children. / Gastroenterol Nurs 2001; 24: 23-7. CrossRef
  2. Arora NK, Ganguly S, Mathur P, Ahuja A, Patwari A. Upper gastrointestinal bleeding: etiology and management. / Indian J Pediatr 2002; 69: 155-68. CrossRef
  3. EL Mouzan MI, Abdullah AM, AI- Mofleh IA. Yield of endoscopy in children with hematemesis. / Trop Gastroenterol 2004; 25: 44-6.
  4. Mittal SK, Kalra KK, Aggarwal V. Diagnostic upper GI endoscopy for hemetemesis in children: experience from a pediatric gastroenterology centre in north India. / Indian J Pediatr 1994; 61: 651-54. CrossRef
  5. Saowaros V, Udayachalerm W, Wee-Sakul B. Causes of upper gastrointestinal bleeding in Thai patients: review of 5000 upper gastrointestinal endoscopy. / J Med Assoc Thai 1994; 77: 561-65.
  6. Cochran EB, Phelps SJ, Tolley EA, Stidham GL. Prevalence of, and risk factors for, upper gastrointestinal tract bleeding in critically ill pediatric patients. / Crit Care Med 1992; 20: 1519-523. CrossRef
  7. Lacroix J, Nadeau D, Laberge S, Gauthier M, Lapierre G, Farrell CA. Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. / Crit Care Med 1992; 20: 35-2. CrossRef
  8. Lopez-Herce J, Dorao P, Elola P, Delgado MA, Ruza F, Madero R. Frequency and prophylaxis of upper gastrointestinal hemorrhage in critically ill children: a prospective study comparing the efficacy of almagate, ranitidine, and sucralfate. The Gastrointestinal Hemorrhage Study Group. / Crit Care Med 1992; 20: 1082-089. CrossRef
  9. Rodgers BM. Upper gastrointestinal hemorrhage. / Pediatr Rev 1999; 20: 171-74. CrossRef
  10. Cox K, Ament ME. Upper gastrointestinal bleeding in children and adolescents. / Pediatrics 1979; 63: 408-13.
  11. Yachha SK, Khanduri A, Sharma BC, Kumar M. Gastrointestinal bleeding in children. / J Gastroenterol Hepatol 1996; 11: 903-07.
  12. Kato S, Nakagawa H, Harada Y, Saito Y, Watanabe N, Abe J / et al. A clinical study of upper gastrointestinal endoscopy in Japanese children. / Acta Paediatr Jpn 1991; 33: 36-2.
  13. Zahavi I, Arnon R, Ovadia B, Rosenbach Y, Hirsch A, Dinari G. Upper gastrointestinal endoscopy in the pediatric patient. / Isr J Med Sci 1994; 30: 664-67.
  14. Stav K, Reif S. Gastrointestinal bleeding in children- etiology and diagnosis. / Harefuah 2000; 138: 534-38.
  15. Mekele J, Haukipuro K, Laitinen S, Kairaluoma MI. Endoscopy for the diagnosis of acute upper gastrointestinal bleeding. / Scand J Gastroenterol 1991; 26: 1082-088. CrossRef
  16. Fishman SJ, Burrows PE, Leichtner AM, Mulliken JB. Gastrointestinal manifestations of vascular anomalies in childhood: varied etiologies require multiple therapeutic modalities. / J Pediatr Surg 1998; 33: 1163-167. CrossRef
  17. Goenka AS, Dasilva MS, Cleghorn GJ, Patrick MK, Shepherd RW. Therapeutic upper gastrointestinal endoscopy in children: an audit of 443 procedures and literature review. / J Gastroenterol Hepatol 1993; 8: 44-1. CrossRef
  18. Balsells F, Wyllie R, Kay M, Steffen R. Use of conscious sedation for lower and upper gastrointestinal endoscopic examinations in children, adolescents, and young adults: a twelve-year review. / Gastrointest Endosc 1997; 45: 375-80. CrossRef
  19. Chang MH, Wang TH, Hsu JY, Lee TC, Wang CY, Yu JY. Endoscopic examination of the upper gastrointestinal tract in infancy. / Gastrointest Endosc 1983; 29: 15-7. CrossRef
  20. Huang IF, Wu TC, Wang KS, Hwang B, Hsieh KS. Upper gastrointestinal endoscopy in children with upper gastrointestinal bleeding. / J Chin Med Assoc 2003; 66: 271-75.
  
• 作者单位：Seyed Mohsen Dehghani (1)
  Mahmood Haghighat (1)
  Mohammad Hadi Imanieh (1)
  Mahmood Reza Tabebordbar (2)
  
  1. Department of Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  2. Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
  

文摘

Objective To find out whether the causes of upper GI bleeding in our center in a developing country differed from developed countries. Methods Children presenting to our center with upper GI bleeding from March 2002 to March 2007, were retrospectively evaluated. Informations were retrieved from patient’s history and physical examination and results of upper GI endoscopy regarding etiology of bleeding, managements, use of medications which might predispose patient to bleeding, and the mortality rate. Results From 118 children (67 boys; with age of 7.7±4.7 yrs) who underwent upper GI endoscopies, 50% presented with hematemesis, 14% had melena and 36% had both. The most common causes of upper GI bleeding among all patients were gastric erosions (28%), esophageal varices (16%), duodenal erosions (10%), gastric ulcer (8.5%), Mallory Weiss syndrome tear (7.8%), duodenal ulcer (6.8%), esophagitis (1.7%) and duodenal ulcer with gastric ulcer (0.8%). The causes of bleeding could not be ascertained in 20.5% of cases. No significant pre-medication or procedure related complications were observed. Endoscopic therapy was performed in 13.5% of patients. In 14.4% of patients, there was a history of consumption of medications predisposing them to upper GI bleeding. Two deaths occurred (1.7%) too. Conclusion The findings in the present study showed that half of upper GI bleedings in pediatric patients from south of Iran, were due to gastric and duodenal erosions and ulcers. This study concludes that the causes of upper GI bleeding in children in our center of a developing country, are not different from those in developed ones.