Upper Gastrointestinal Bleeding in Children and Adolescents

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 408-413
Author(s):  
Kenneth Cox ◽  
Marvin E. Ament
Keyword(s):  
Children And Adolescents ◽  
Signs And Symptoms ◽  
Gastric Ulcers ◽  
Coagulation Disorder ◽  
Duodenal Ulcers ◽  
Male Predominance ◽  
Transfusion Requirements ◽  
Common Causes ◽  
Life Threatening ◽  
Upper Gastrointestinal

This is a retrospective study of upper gastrointestinal testinal hemorrhage in 68 children and adolescents who were less than 19 years old. In descending order of frequency, the five most common causes were duodenal ulcers, gastric ulcers, esophagitis, gastritis, and esophageal varices. There was male predominance in all diagnoses except gastric ulcers and gastritis. Signs and symptoms correlated poorly with the source of bleeding. Endoscopy was the most reliable method of identifying the bleeding site. Mortality correlated with the following: (1) initial hematocrit or hemoglobin level of <20% or <7 gm/100 ml, respectively, (2) transfusion requirements of >85 ml/kg of blood without surgical intervention, (3) failure to identify the source of bleeding, (4) presence of a coagulation disorder, and (5) coexistence of another life-threatening disease.

scholarly journals Incidence of Duodenal Ulcers and Gastric Ulcers in a Western Population: Back to Where It Started

2009 ◽  
Vol 23 (9) ◽  
pp. 604-608 ◽  
Author(s):  
Marcel JM Groenen ◽  
Ernst J Kuipers ◽  
Bettina E Hansen ◽  
Rob J Th Ouwendijk
Keyword(s):  
Gastric Ulcers ◽  
Bleeding Complications ◽  
Upper Gastrointestinal Endoscopy ◽  
Peptic Ulcers ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Treatment Regimens ◽  
H Pylori ◽  
Upper Gastrointestinal ◽  
Over Time

BACKGROUND/OBJECTIVES: As recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. The discovery of Helicobacter pylori had a further major impact on the incidence of ulcer disease. Our aim was to evaluate the trends in the incidence and bleeding complications of ulcer disease in the Netherlands.METHODS: From a computerized endoscopy database of a district hospital, the data of all patients who underwent upper gastrointestinal endoscopy from 1996 to 2005 were analyzed. The incidence of duodenal and gastric ulcers, with and without complications, were compared over time.RESULTS: Overall, 20,006 upper gastrointestinal endoscopies were performed. Duodenal ulcers were diagnosed in 696 (3.5%) cases, with signs of bleeding in 158 (22.7%). Forty-five (6.5%) of these ulcers were classified as Forrest I and 113 (16.2%) as Forrest II. Gastric ulcers were diagnosed in 487 cases (2.4%), with signs of bleeding in 60 (12.3%). A Forrest 1 designation was diagnosed in 19 patients (3.9%) and Forrest 2 in 41 patients (8.4%). The incidence of gastric ulcers was stable over time, while the incidence of duodenal ulcers declined.CONCLUSIONS: The incidence of duodenal ulcer disease in the Dutch population is steadily decreasing over time. Test and treatment regimens for H pylori have possibly contributed to this decline. With a further decline in the prevalence of H pylori, the incidence of gastric ulcers is likely to exceed the incidence of duodenal ulcers in the very near future, revisiting a similar situation that was present at the beginning of the previous century.

scholarly journals Etiology and treatment of chest pain in children and adolescents

2020 ◽  
Vol 63 (7) ◽  
pp. 382-389
Author(s):  
Kyung Lim Yoon
Keyword(s):  
Chest Pain ◽  
Children And Adolescents ◽  
Cardiac Diseases ◽  
Common Symptom ◽  
Common Causes ◽  
Pediatric Chest ◽  
Life Threatening ◽  
Red Flag ◽  
Benign Nature ◽  
Complete History

Chest pain is a very common symptom in pediatric patients. Although children with chest pain are relatively unlikely to be suffering from significant cardiac diseases, it is important not to overlook life-threatening diseases. Complete history taking and physical examination––which involves identifying the duration of pain, onset, character, associated symptoms, and aggravating factors––are extremely important. The most common causes of pediatric chest pain are idiopathic and musculoskeletal, while less than 3% of cases are of cardiac origin. Recent studies indicate that chest pain resulted from psychosomatic disorders increases in non-cardiac chest pain in children and adolescents. The reassurance of the benign nature of chest pain is enough in most cases of non-cardiac chest pain in children and adolescents. When echocardiography is performed on patients with exertional chest pain, it is important to confirm the origin of coronary artery to exclude any coronary anomaly. Exertional chest pain, combined syncope, and symptoms of myocardial ischemia should raise the suspicion of significant cardiac diseases. When the chest pain is accompanied by red flag signs, physicians must refer the patients to a pediatric cardiologist.

scholarly journals Acute gastric volvulus: case report and review of the literature

CJEM ◽  
1999 ◽  
Vol 1 (03) ◽  
pp. 200-203 ◽  
Author(s):  
William E. Sevcik ◽  
Ivan P. Steiner
Keyword(s):  
Gastric Volvulus ◽  
Signs And Symptoms ◽  
Illustrative Case ◽  
Emergency Physicians ◽  
Review Of The Literature ◽  
Gastrointestinal Obstruction ◽  
Acute Gastric Volvulus ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
Upper Gastrointestinal

ABSTRACT: Gastric volvulus is a rare but potentially life-threatening cause of upper gastrointestinal obstruction. Emergency physicians must maintain a high index of suspicion in patients who present with signs and symptoms suggesting foregut occlusion. We report an illustrative case and review the pathogenesis, classification, diagnosis and treatment of this rare entity.

scholarly journals The Changing Pattern of Upper Gastrointestinal Disorders by Endoscopy: Data of the Last 40 Years

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Erkan Caglar ◽  
Birol Baysal ◽  
Ahmet Dobrucalı
Keyword(s):  
Esophageal Cancer ◽  
Female Gender ◽  
Gastric Ulcers ◽  
Erosive Gastritis ◽  
Duodenal Ulcers ◽  
Time Period ◽  
The Mean ◽  
And Gender ◽  
Upper Gastrointestinal ◽  
Made In

Objectives. We have investigated the changes in the incidence of various diagnoses that have been made in the endoscopy unit throughout the last 40 years. Methods. In this study, changes in the incidence of endoscopic diagnosis in upper gastrointestinal system between 1970 and 2010 were evaluated. Their diagnosis, age, and gender data were entered into the Excel software. Results. Of the 52816 cases who underwent esophagogastroduodenoscopy in the 40-year time period, the mean age was 48.17 ± 16.27 (mean ± SD). Although overall more than half of the patients were male (54.3%), in 1995 and after a marked increase was seen in the proportion of female gender (51–55%). The presence of hiatal hernia, reflux esophagitis, and the number of Barrett’s esophaguses significantly increased. Erosive gastritis showed gradual increase, while the number of gastric ulcers decreased significantly. The presence of gastric and esophageal cancer significantly decreased. The number of duodenal ulcers significantly decreased. Conclusion. We detected that the incidences of esophagitis, Barrett’s esophagus, and erosive gastritis significantly increased while the incidences of gastric/duodenal ulcer and gastric/esophageal cancer decreased throughout the last 40 years.

scholarly journals Acute Upper Gastrointestinal Bleeding in a Tertiary Care Centre of Nepal

2017 ◽  
Vol 56 (206) ◽  
Author(s):  
Mukesh Sharma Paudel ◽  
Sudhamshu KC ◽  
Amrendra Kumar Mandal ◽  
Nandu Silwal Poudyal ◽  
Ramila Shrestha ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Tertiary Care ◽  
Gastric Ulcers ◽  
Peptic Ulcers ◽  
Tertiary Care Centre ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Acute Upper Gastrointestinal Bleeding ◽  
Variceal Bleed ◽  
Upper Gastrointestinal

Introduction: AUGIB is characterized by hematemesis or melena or both. Peptic ulcers and variceal bleed account for majority of cases. Use of proton pump inhibitors in current era is associated with a gradual reduction in burden of peptic ulcer disease. We conducted this study to look into the cause of AUGIB in our community.Methods: We studied 100 patients in one year period who presented to us with hematemesis or melena. The study was conducted in department of Gastroenterology, Bir hospital, Kathmandu. We identified the culprit lesions by upper gastrointestinal endoscopy.Results: The average age of patients with AUGIB was 51.6 years with 59 (59%) males. Duodenal ulcers are most common 29 (29%), followed by varices 23 (23%) and gastric ulcers 14 (14%). More than one lesion was identified in 38 (38%) patients. Patients with variceal bleed were more likely to present with hematemesis alone as compared to those with ulcer bleed (p=0.005). Variceal bleed patients presented earlier to the hospital (p=0.005), had lower MAP at presentation (p=0.0002), had lower hemoglobin level (p=0.0001) and higher serum creatinine level at presentation (p=0.001). Patients with variceal bleed were more likely to have consumed alcohol 20 (86.9%) and patients with ulcer bleed were more likely to be smokers 29 (67.4%) or consume tobacco 14 (32.5%) (p=0.006).Conclusions: Ulcer related bleeding is still the most common cause of AUGIB. Many patients with AUGIB have more than one lesions identified during upper gastrointestinal endoscopy.Keywords:  bleeding; endoscopy; peptic ulcer; upper gastrointestinal;varices. [PubMed]

Lower gastrointestinal bleeding

2018 ◽  
Vol 11 (3) ◽  
pp. 138-142 ◽  
Author(s):  
Rodrick Babakhanlou
Keyword(s):  
Gastrointestinal Tract ◽  
Clinical Presentation ◽  
Lower Gastrointestinal Bleeding ◽  
Intestinal Bleeding ◽  
Fresh Blood ◽  
Common Causes ◽  
Life Threatening ◽  
Ligament Of Treitz ◽  
The Common ◽  
Upper Gastrointestinal

Lower intestinal bleeding covers a spectrum of intestinal bleeding originating distal to the ligament of Treitz. In 11% of cases, the source of bleeding will be found in the upper gastrointestinal tract. Lower intestinal bleeding can occur either in the form of fresh blood, also known as haematochezia, or in the form of black, tarry and foul-smelling stools, also known as melaena. It can be chronic and mild or severe and life-threatening. This article will focus on the common causes of lower intestinal bleeding, clinical presentation, assessment and management, as well as providing guidance for referral to secondary care.

The tactics of managing children and adolescents when twisting the uterine appendages from the position of international standards

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 39-41
Author(s):  
Zalina K. Batyrova ◽  
Zaira K. Kumykova ◽  
Elena V. Uvarova ◽  
Vladimir D. Chuprynin ◽  
Natalya A. Buralkina ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Ovarian Tissue ◽  
Standard Of Care ◽  
Lymphatic Drainage ◽  
International Standards ◽  
Delivery Of Care ◽  
National Medical ◽  
Treatment Standard ◽  
Common Causes ◽  
Adolescent Gynecology

Background. Adnexal torsion (AT) takes fifth place among all emergency gynecological conditions. Suspicion of AT requires immediate diagnosis and urgent surgical treatment. The most common causes of AT are various volumetric formations, such as functional or dermoid ovarian cysts, contributing to an increase in its volume and/or anomalies in the development of the ligamentous apparatus. Timely diagnosis and detorsion contributes to the full restoration of impaired venous outflow and lymphatic drainage of the ovarian tissue, preventing the development of severe ischemia and necrosis. Over the past few decades, a surgical organ-preserving approach in managing patients with AT has been the gold standard of care. Materials and methods. The article describes the results of a retrospective study of cases of AT in children and adolescents treated at the Department of Pediatric and adolescent gynecology Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology with an assessment of the clinical and anamnestic features of this cohort of patients and the choice of therapeutic tactics. Conclusion. A multidisciplinary approach is critical to optimizing the delivery of care in cases of AT, including minimally invasive detorsion and preserving the functionality of the ovary as a treatment standard that should be used in the management of children and adolescents.

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