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697 Endoscopic and Histopathological Findings in Children with Upper Gastrointestinal Bleeding
  1. OF Beser,
  2. E Celik,
  3. S Lacinel,
  4. T Kutlu,
  5. T Erkan,
  6. FC Cokugras
  1. Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey

Abstract

Introduction The etiology changes according to the age of child for upper gastrointestinal system(GI) bleeding. Esophagogastroduodenoscopy (EGD) is used to determine the source of upper GI bleeding in 90% of children when performed in the first 24 hours.

Aim In this study we aimed to determine the etiology of the upperGI bleeding in children. In order to determine the etiology we evaluated the EGD and biopsy findings.

Methods We evaluated the EGD and biopsy findings of children who complaint of upperGI bleeding.

Results Eighteen children were in newborn period. We detected that 12 of infants hematemesis was due to swallowed maternal blood by Apt-Downey test. EGD was performed to 6of newborns and 4of them had no pathology but 2 had vascular malformations. Eight children were below 1year of age. We detected Mallory Weiss tear in two infants and moderate severe esophagitis findings was seen on biopsy materials. Six of these cases have both macroscopic and microscopic findings of gastritis on antrum and H.pylori(+). There were 22 cases above 1year old. Four of them had ulcer on bulbus. Six of them had esophageal varices. Mallory Weiss tear was detected on 3 of 12 cases and their biopsies were consistent with moderate-svere esophagitis. Macrosopically gastritis on the antral part was detected in 9 cases and biopsies were consistent with active gastritis and also all ofthem was H.pylori (+).

Conclusion In order to indicate the severity of bleeding it is very important to determine the bleeding site and etiology of bleeding. So that a detailed history and complete physical examination is very important. The importance of endoscopy in determintaion of etiology is undisputed.

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