Epidemiology of lower gastrointestinal bleeding in China: Single‐center series and systematic analysis of Chinese literature with 53 951 patients

Per rectal bleeding is a frequently encountered clinical complaint in routine medical/surgical practice in paediatric patients. It has different aetiology in both extremes of age. This study was carried out in an attempt to find out causes, presentation and the proper management that can be offered to the affected infants and children.This retrospective study was carried out from January 2012 to December 2014 in the department of Paediatric Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. All patients presenting with the complaint of per rectal bleeding were included. But patients who needed emergency surgical intervention were excluded from this study. The data were reviewed for gender, age, causes of rectal bleeding and type, number, site, recurrence rate and the modality of treatment employed in children having colorectal polyp. Technetium-labeled red blood cells scans was used for the diagnosis of Meckel's Diverticulum. Complete blood picture and routine stool examination were done for all cases.Most polyp cases were diagnosed with digital rectal examination (DRE). Colonoscopy was performed for some cases in the Paediatric Gastroenterology Department of BSMMU. Also all the rectal polyps and colonic mucosal biopsies taken during colonoscopy submitted to histopathological examination. Per rectal bleeding was the chief complaint in 326 (1.5%) patients Out of 21,533 patients presenting to the outpatient department of Paediatric Surgery of BSMMU, Dhaka, Bangladesh over a period of three years. In this study, it was reviewed 326 patients, among them 208 (63.89%) were boys and 118 (36.19%) were girls. The male female ratio was 1.8:1. The ages ranged from 14 months to 14 years (mean age: 5.8years) at diagnosis. The most common aetiology was juvenile polyps which were found in 209 (64.11%) of the cases. It was to be found that anal fissure in 33 (10.12%) patients, rectal prolapse in 27 (8.2%) patients, non-specific colitis in 15 (4.60%) patients, Meckel's Diverticulitis in 3 (0.9%) patients, juvenile polyposis coli in 5 (1.5%) patients and familial adenomatous polyposis coli (FAP) in 4 (1.2%) patients. However, the cause of per rectal bleeding remained unknown suspecting chronic constipation in 30 (9.20%) patients. No statistically significant differences were observed between males and females as well as different age groups regarding the means of the underlying causes of per rectal bleeding in children(p > 0.05). The prevalence of anal fissure in less than 2 years old patients and juvenile polyps in the 2-6 years old patients were significantly higher than the other causes (p < 0.001). Other causes of per rectal bleeding prevailed in children were more than 2 years old. Colorectal polyps are common causes of per rectal bleeding in children. Proper physical examination including DRE along with the colonoscopy promotes both rapid and accurate diagnosis and the opportunity for immediate therapeutic measures.

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“…24 In this study, the prevalence of colorectal polyp in the 2-6 years old group was higher in comparison to the other groups.…”

Section: Discussionmentioning

confidence: 42%

Per Rectal Bleeding in Children: Experiences in the Department of Paediatric Surgery in BSMMU

Alam

Islam

Mahammad³

et al. 2018

Bangladesh Med Res Counc Bull

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“…12 In a study done in India, the common causes of LGIB were non-specific ulcers, ileal tuberculosis, NSAID enteropathy, enteric fever, Meckel's diverticulum, followed by the more common diagnoses found in the West. 13 It has been shown in different studies that 80% of adult LGIB are usually asymptomatic and among them approximately 80% will cease spontaneously.…”

Section: Discussionmentioning

confidence: 99%

Etiological profile, gender difference and age group patterns of 415 patients presenting with lower gastrointestinal bleeding in the western region of Nepal

Shrestha

2015

J Adv Intern Med

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“…In another study in Iran, of 164 colonoscopies, 34.7% of LGBI were due to polyps which was the most common etiology followed by lymphoid nodular hyperplasia (22.5%) (21). Bai et al (6) found that the proportion of colorectal polyp induced LGIB increased with the patients' age. In our study, the prevalence of colorectal polyp in the 2-6 years old group was higher in comparison to the other groups.…”

Section: Discussionmentioning

confidence: 99%

“…Farrell and Friedman (2005) reported the incidence of LGIB as 20.5 to 27 cases per 100,000 adults in the U.S. (5). Bai et al (2010) investigated 160 studies which provided the data of 53951 patients with LGIB in china (6). Based on these studies, colorectal cancer, colorectal polyps, colitis, anorectal disease, and inflammatory bowel disease were the most prevalent etiologies of LGIB in the Chinese adult population.…”

Section: Discussionmentioning

confidence: 99%

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Lower Gastrointestinal Bleeding in Children: Experiences From Referral Center in Southern Iran

et al. 2013

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Background: Lower gastrointestinal bleeding (LGIB) in infants and children is a common problem in medical centers; however, its epidemiologic properties have not been studied well. Objectives: Due to the fact that LGIB has various causes in different geographical places, considering the importance of etiology in decision making for diagnostic techniques and treatment and since the lack of comprehensive database related to this issue, the main purpose of the current study was to determine the main causes of LGIB in children in a single center from Southern Iran. Patients and Methods:The study was conducted on all the patients less than 18 years old with LGIB who referred to Pediatric Gastroenterology Ward affiliated with Shiraz University of Medical Sciences between 2005 and 2009. The data, including the patients' sex, age, and endoscopic as well as pathological findings, were collected and analyzed. Results: Overall, our series included a total of 309 patients with LGIB (185 males and 124 females) below 18 years old. The most common causes of LGIB included colorectal polyps (n = 90; 29.1%), lymphoid nodular hyperplasia (n = 62; 20%), solitary rectal ulcer (n = 31; 10%), and inflammatory bowel disease (n = 20; 6.5%). Nevertheless, no obvious causes were identified in 30.7% of the patients. The prevalence of lymphoid nodular hyperplasia in less than 2 years old patients and colorectal polyps in the 2-6 years old patients were significantly higher than the other causes (P = 0.001). The most cases with inflammatory bowel diseases and solitary rectal ulcer were more than 2 years old. On the other hand, no statistically significant differences were observed between males and females as well as different age groups regarding the means of the underlying causes of LGIB (P > 0.05). Conclusions:The results of present study could be used by the Iranian physicians in order to gain an overall picture of LGIB in Iran and guide the management of the patients with LGIB.

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Epidemiology of lower gastrointestinal bleeding in China: Single‐center series and systematic analysis of Chinese literature with 53 951 patients

Cited by 35 publications

References 22 publications

Per Rectal Bleeding in Children: Experiences in the Department of Paediatric Surgery in BSMMU

Per Rectal Bleeding in Children: Experiences in the Department of Paediatric Surgery in BSMMU

Etiological profile, gender difference and age group patterns of 415 patients presenting with lower gastrointestinal bleeding in the western region of Nepal

Lower Gastrointestinal Bleeding in Children: Experiences From Referral Center in Southern Iran

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