Article Text

ETIOLOGY OF UPPER GASTROINTESTINAL BLEEDING IN CHILDREN IN SOUTHERN IRAN
  1. S M Dehghani1,
  2. M Haghighat1,
  3. M H Imanieh1,
  4. M R Tabebordbar1
  1. 1Department of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz, Iran

Abstract

Objective Upper gastrointestinal (GI) bleeding is defined as bleeding proximal to ligament of Treitz and a prompt diagnosis and an appropriate management is very important. The aim of this study was to find out whether the causes of upper GI bleeding in our center in a developing country differed from developed ones.

Methods Children presenting to our center with upper GI bleeding from March 2002 to March 2007 were retrospectively evaluated. Information retrieved from patient’s records and results of upper GI endoscopy regarding etiology of bleeding, managements, and the mortality rate.

Results From 118 children (67 boys; with age of 7.7±4.7 years), 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 tear (7.8%), duodenal ulcer (6.8%), esophagitis (1.7%) and duodenal ulcer with gastric ulcer (0.8%). Cause of bleeding could not be ascertained in 20.5% of cases. 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 Our findings showed that half of upper GI bleedings in pediatric patients from south of Iran were due to gastric and duodenal erosions and ulcers. We conclude that the causes of upper GI bleeding in children in our center, a developing country, are not different from those in developed ones.

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