Gastrointestinal Bleeding in Children: Current Management, Controversies, and Advances

Inna Novak; Lee M Bass

doi:10.1016/j.giec.2022.11.003

Gastrointestinal Bleeding in Children: Current Management, Controversies, and Advances

Gastrointest Endosc Clin N Am. 2023 Apr;33(2):401-421. doi: 10.1016/j.giec.2022.11.003.

Authors

Inna Novak¹, Lee M Bass²

Affiliations

¹ Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital at Montefiore, Albert Einstein College of Medicine, 3415 Bainbridge Avenue, Bronx, NY 10467, USA. Electronic address: inovak@montefiore.org.
² Division of Gastroenterology, Hepatology and Nutrition, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, 225 E Chicago Avenue, Chicago, IL 60611, USA.

PMID: 36948753
DOI: 10.1016/j.giec.2022.11.003

Abstract

Upper gastrointestinal bleeding (UGIB) in children has many causes, with its prevalence varying by age. Often presenting as hematemesis or melena, the initial treatment is stabilization of the patient, including protection of the airway, fluid resuscitation, and a transfusion hemoglobin threshold of 7 g/L. Endoscopy should be performed with the goal of using combinations of therapies to treat a bleeding lesion, generally involving epinephrine injection along with either cautery, hemoclips, or hemospray. This review discusses the diagnosis and treatment of variceal and non-variceal gastrointestinal bleeding in children with a focus on current advances in the treatment of severe UGIB.

Keywords: Epinephrine; Esophageal varices; Hemoclips; Pediatric endoscopy; Portal hypertension; Transfusion; Ulcer; Upper gastrointestinal bleeding.

Publication types

Review

MeSH terms

Child
Endoscopy, Gastrointestinal / adverse effects
Esophageal and Gastric Varices*
Gastrointestinal Hemorrhage / diagnosis
Gastrointestinal Hemorrhage / etiology
Gastrointestinal Hemorrhage / therapy
Humans
Prevalence