scholarly journals An assessment of the causes of lower gastrointestinal bleeding in a children’s hospital in northeastern Romania

2015 ◽  
Vol 67 (2) ◽  
pp. 715-720
Author(s):  
Nicoleta Gimiga ◽  
Marin Burlea ◽  
Smaranda Diaconescu ◽  
Claudia Olaru

The aims of this five-year retrospective study was to investigate the common etiologies, clinical, biological and pathological patterns of lower gastrointestinal bleeding in children from a hospital center in northeastern Romania. We included in the study 118 children with lower gastrointestinal hemorrhage or two consecutive positive fecal occult blood tests. Patients were divided into three age groups (0-2 years, 3-10 years, 11-18 years) and the findings were reported separately for each group. Gastrointestinal bleeding was more common among 3-10-year-old children. Hematochezia was the most common form of presentation (54.2%), followed by rectorrhagia (40.7%). Each patient underwent a colonoscopy with bioptic mapping. The most common colonoscopy finding was solitary colorectal polyps in 39 cases (33.1%), followed by suggestive aspects for ulcerative colitis in 26 patients (22.0%); only 15 (12.7%) were histologically confirmed. Endoscopic polypectomy was performed in all cases. We report two perforations and one hemorrhage that required surgery.

2019 ◽  
Author(s):  
yun liu ◽  
XiuWen Chen ◽  
ShengHua Wan

Abstract Background: In a clinical setting, the common causes of lower gastrointestinal bleeding are often easy to identify, but some cases require detailed examinations to make a diagnosis. At present, the cause of lower gastrointestinal bleeding is unclear. The aim of this study was to review cases of children hospitalized for lower gastrointestinal bleeding in the past 5 years at our hospital and analyze the etiologies according to age group.Methods: In this study, we statistically analyzed the etiologies of lower gastrointestinal bleeding in children of different ages and sexes from Jiangxi Province, China. From January 2013 to August 2018, 8,036 patients hospitalized for lower gastrointestinal bleeding in Jiangxi Provincial Children’s Hospital were divided into groups to analyze the etiologies.Results: Of these 8,036 patients, 7,827 were clearly diagnosed. Etiologies included intussusception (4,741 cases, 60.6%), infectious diarrhea (2,171 cases, 27.7%), colon polyps (405 cases, 5.2%), Meckel’s diverticulum (292 cases, 3.7%), allergic colitis (113 cases, 1.4%), anal fissures (34 cases, 0.4%), Henoch-Schönlein purpura (27 cases, 0.3%), eosinophilic gastrointestinal disease (27 cases, 0.3%), and inflammatory bowel disease (17 cases, 0.2%). Generally, the condition presents with blood in the stool, bloody diarrhea, or fecal occult blood. Abdominal color Doppler ultrasonography, colonoscopy, computed tomography, 99 m Tc pertechnetate imaging, and other blood tests can aid in the diagnosis.Conclusions: We found that the type of lower gastrointestinal bleeding in children is related to age. Intussusception was the most common cause of intestinal obstruction overall and in infants between 6 and 36 months of age. Treatment of children with lower gastrointestinal bleeding should be based on prevention. Medical staff should actively raise awareness of the condition, identify the severity of the disease in a timely manner, make early diagnoses, provide prompt treatment, and cooperate with providers in multiple disciplines to save patients’ lives. Keywords: lower gastrointestinal bleeding, children, etiology, intussusception


2014 ◽  
Vol 39 (2) ◽  
pp. 52-56 ◽  
Author(s):  
F Yeasmin ◽  
MA Ali ◽  
MA Rahman ◽  
T Sultana ◽  
MQ Rahman ◽  
...  

Fecal occult blood test is the most widely used screening test for diagnosis of gastrointestinal bleeding disorders specially colorectal carcinoma. Among the various methods of fecal occult blood tests, chemical method is being used commonly, but the method has some drawbacks like low participation rate, high false positive rate, low sensitivity etc. To overcome these short comings, newer immunological method was introduced. This study evaluated the role of immunological method of fecal blood test in the diagnosis of occult lower GIT bleeding. Stool samples from two hundred patients were examined by both chemical and immunological method. The patients who were positive by any or both methods of occult blood test, were advised for colonoscopy. During colonoscopy tissues were taken for histopathology which was the gold standard of this study. Among 110 OBT positive patients pathological lesions were detected in 65 patients by colonoscopy and histopathology. The diseases detected by colonoscopy and histopathology 18 colorectal polyp, 8 colorectal cancer, 24 ulcerative lesions and 5 inflammatory bowel disease etc. Regarding comparative analysis of chemical and immunological method, the higher sensitivity (95.4% vs. 49.2%), specificity (44.4% vs. 37.8%), accuracy (74.5% vs. 44.5%), PPV (71.3% vs. 53.3%) and NPV (87% vs. 34%) of immunological method than chemical method was observed. Thus immunological method of fecal occult blood test was appeared to be a better alternative to conventional chemical method of fecal occult blood test in the diagnosis of occult lower GIT bleeding. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19641 Bangladesh Med Res Counc Bull 2013; 39: 52-56


2015 ◽  
Vol 110 ◽  
pp. S1031-S1032
Author(s):  
Amaninder Jeet Singh. Dhaliwal ◽  
Garen Derhartunian ◽  
Irina Laptevsky ◽  
Sarvani Madiraju ◽  
Saw Sein ◽  
...  

1995 ◽  
Vol 20 (1) ◽  
pp. 78-88
Author(s):  
Cristina Yges ◽  
José L. Chicharro ◽  
Alejandro Lucía ◽  
Julio C. Legido ◽  
Fernando Bandrés

The purpose of this investigation was to determine the incidence of fecal occult blood in marathoners using an immunochemical technique (OC-Hemodia). Five stool specimens (2 pre- and 3 postrace) were collected from 24 male runners (mean age 41.4 ± 9.3 yrs) and analysed for fecal occult blood using the OC-Hemodia test. The results were also compared with a qualitative test (Hemofec) in 12 subjects who were randomly selected from the overall group of 24 runners. With the immunochemical technique, the results evidenced the presence of fecal occult blood in 8 subjects in the first postrace stool specimens. Four of these 8 subjects also tested positive in the second postrace sample, whereas in the third postrace sample only one of them tested positive. With the qualitative test, fecal blood was demonstrated in 10 runners in the first postrace sample. Eight of them tested positive in the second sample, whereas only 5 tested positive in the third sample. The immunochemical technique is recommended for fecal occult blood detection in marathoners. Key words: gastrointestinal bleeding, immunochemical technique, marathon


2018 ◽  
Vol 84 (8) ◽  
pp. 1345-1349
Author(s):  
Leen Khoury ◽  
David Hill ◽  
Miroslav Kopp ◽  
Melissa Panzo ◽  
Tushar Bajaj ◽  
...  

With the advent of proton pump inhibitors and H. Pylori treatment, the old dogma “the most common cause of lower GI bleeding is upper GI bleeding” may no longer be valid. We sought to determine the most common causes of GI bleeding in patients without an obvious source and their clinical outcomes. We queried our hospital database for GI hemorrhage during 2015, excluding patients with obvious sources such as hematemesis or anal pathology. We collected data from patients with GI bleeding defined as bright red blood per rectum, melena, or a positive fecal occult blood test. The primary endpoints were etiology of GI bleed, amount of transfusions required, and types of interventions performed. Ninety-three patients were admitted with GI bleeding as defined previously: mean age was 74 years and mean hemoglobin was 8.2. Seventy-four per cent received blood transfusions with an average of 2 units transfused per patient; 22 per cent received 3 or more units of blood. The etiology of bleeding was 17 per cent upper GI source, 15 per cent lower GI source, and in 68 per cent, the source remained unknown. Bleeding stopped spontaneously in 86 per cent of patients and 9 per cent died. Endoscopy was performed in 71 per cent, but only 6 per cent underwent therapeutic endoscopic intervention. No patient had surgical or interventional radiologic procedures related to their GI bleed. Gastrointestinal bleeding, without an obvious source on presentation, rarely requires operative intervention or interventional radiologic procedure. Blood transfusions were not predictive of the need for therapeutic endoscopic intervention which was required in only 6 per cent of patients.


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