MASSIVE UPPER GASTROINTESTINAL HEMORRHAGE IN CHILDREN

Publisher Website
Google Scholar
Abstract
1. Although gastrointestinal bleeding is rare in children, the same aggressive approach to early diagnosis is warranted as is now advised in adults.2. Portal vein thrombosis is the single most common cause of massive upper gastrointestinal bleeding in children after infancy. This diagnosis should be suspected in a child with splenomegaly, normal liver chemistries and past history of umbilical vein catheterization. Early endoscopy and splenoportography are a vital part of this evaluation. Treatment may be temporized since these patients usually respond to medical management and it is desirable to postpone venous shunting procedures until the child is older.3. In the absence of clinical history of peptic disorder and no evidence of splenomegaly, the most important examination in detection of upper gastrointestinal bleeding is celiac and mesenteric angiography. This should be accomplished promptly during active bleeding. A negative gastrointestinal series makes angiography even more pressing, but delays it b...

This publication has 0 references indexed in Scilit: