Etiology of gastrointestinal bleeding in children referred to pediatric wards of Mashhad hospitals, Iran

Jafari, Seyed Ali; Kiani, Mohammad Ali; Kianifar, Hamid Reza; Mansooripour, Mohammad; Heidari, Elahe; Khalesi, Maryam

doi:10.19082/6341

Cited by 9 publications

(18 citation statements)

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“…After confirmation of bleeding as LGIB, proctosigmoidoscopy followed by colonoscopy is recommended among all cases for further evaluation and diagnosis. 3,7 Colonoscopy is proved to be a safe and effective tool for investigating lower GI pathologies among children. 8 Advantages of colonoscopy included direct visualization and identification of the source of bleeding, numerous management possibilities and effective diagnostic as well as therapeutic tool.…”

Section: Introductionmentioning

confidence: 99%

Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital

et al. 2021

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Objective: To determine etiology and outcome of children with lower gastrointestinal bleeding (LGIB). Methods: This was a prospective study conducted at the Department of Pediatric Gastroenterology and Hepatology, Children’s Hospital and The Institute of Child’s Heath, Multan, Pakistan, from July 2019 to March 2020. A total of 148 cases presented with bleeding per rectum and underwent colonoscopy, were included. Children of both genders and aged three month to 15 years were included. Detailed history, clinical examination, laboratory studies, colonoscopy and histopathology were done in all cases. Study information like demographics, complaints, general clinical examination, colonoscopy and histopathological findings were recorded. Results: Overall, mean age was noted to be 7.20±1.83 years. Abdominal pain was reported in 41 (27.7%), diarrhea 36 (24.3%), fever 12 (8.1%) and constipation in 4 (2.7%). Pallor was noted among 68 (45.9%), weight loss 39 (26.3%) and tachycardia 31 (20.9%). Colonoscopy revealed juvenile colonic / rectal polyps, infectious colitis and solitary rectal ulcer (SRU) as the most common etiologies found among 58 (39.2%), 20 (13.5%) and 19 (12.8%) cases respectively. Juvenile polyps and non-specific colitis were the commonest histopathological findings seen in 55 (37.2%) and 20 (13.5%) cases respectively. Colonoscopic polypectomy was used to remove all juvenile polyps. Conclusion: LGIB is presentation of various underlying causes. Children with LGIB commonly present with abdominal pain. Juvenile polyps were the most frequent cause of LGIB among children flowed by non-specific colitis. Most of the children having LGIB were diagnosed and treated successfully, few are in remission and very few were found resistant to treatment. doi: https://doi.org/10.12669/pjms.37.2.2676 How to cite this:Talib MA, Aziz MT, Suleman H, Khosa GK, Joya SJ, Hussain I. Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2676 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 99%

Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital

et al. 2021

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“…Experience from different countries shows differences in the prevalence of the most common causes of LGIB in children. The aetiology of LGIB may differ depending on the studied population and the diagnostic methods used [7,[9][10][11][12]. Differences may be due to various reasons, including lifestyle, dietary habits, ethnicity, and geographic conditions.…”

Section: Discussionmentioning

confidence: 99%

“…In adolescents the predominant causes include anal fissures, infectious enterocolitis, colorectal polyps, and IBD [1]. Experiences in various countries and among different populations indicate differences in the prevalence of a variety of causes of LGIB in children [1,7,8]. For instance findings from the Iran study indicated that polyps, chronic nonspecific colitis and proctitis are the most prevalent causes of LGIB in children [7].…”

Section: Introductionmentioning

confidence: 99%

“…Experiences in various countries and among different populations indicate differences in the prevalence of a variety of causes of LGIB in children [1,7,8]. For instance findings from the Iran study indicated that polyps, chronic nonspecific colitis and proctitis are the most prevalent causes of LGIB in children [7]. Another study shows that allergic colitis and anorectal fissures represent the most common causes in infants, while infectious enteritis and anorectal fissures are the most common causes in older children [9].…”

Section: Introductionmentioning

confidence: 99%

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A child with lower gastrointestinal bleeding – aetiology and diagnostic procedure

Jamer¹,

Maleika²,

Borys-Iwanicka³

et al. 2022

polp

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Introduction: Lower gastrointestinal bleeding (LGIB) is not a rare clinical problem in children. The aetiology of LGIB varies according to age. Likewise, experiences in different countries reflect the disparities in the frequency of various causes of LGIB in children. Although some cases can be diagnosed clinically, choosing the appropriate diagnostic methods in children is challenging. The aim of the study was to determine the aetiology of LGIB in children and analyse the diagnostic procedures needed to make a diagnosis. Material and methods:The medical records of children with chronic LGIB admitted to the Paediatric Gastroenterology Department were reviewed. The diagnoses and diagnostic procedures were analysed according to age groups (< 5 with subgroups < 2 and 2-5, 5-10, and > 10 years old). Results: 227 patients were enrolled in the study. The most important causes of LGIB among all patients were constipation associated with anal fissures (36.6%) and inflammatory bowel disease (IBD) (33.5%). According to age groups, the main causes of LGIB were: up to 5 years old -constipation (39.62%) and food allergy (28.3%), in the youngest age subgroup up to 2 years old -food allergy (52.38%), between 5 and 10 years old -constipation (44%) and ulcerative colitis (14%), over 10 years old -IBD ulcerative colitis (36.29%), Crohn's disease (13.71%), and constipation (32.26%). Patients with IBD were more likely to have anaemia and weight loss. The level of faecal calprotectin was significantly elevated in children with IBD and colorectal polyps. Conclusions: Constipation is a common cause of LGIB in all age groups of children. Food allergy should be considered in infants and young children, but it is rarely seen in children over 5 years old. In children older than 5 years old, diagnostics for IBD should be carried out, especially in patients with weight loss, high levels of faecal calprotectin, and anaemia. Colorectal polyps and Meckel's diverticulum are less common causes of LGIB.

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“…Anal fissures in infants often present with painful defecation: straining, grunting, leg stiffening or back arching consistent with withholding behavior, and streaks of bright-red blood on the surface of the stools. Generally, anal fissures are associated with diarrhea and constipation [13]. They are easily diagnosed by spreading the perineal skin to evert the anal canal.…”

Section: Yearsmentioning

confidence: 99%

Etiology analysis of lower gastrointestinal bleeding in children

liu

Chen

Shenghua

2019

Preprint

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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

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Etiology of gastrointestinal bleeding in children referred to pediatric wards of Mashhad hospitals, Iran

Cited by 9 publications

References 25 publications

Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital

Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital

A child with lower gastrointestinal bleeding – aetiology and diagnostic procedure

Etiology analysis of lower gastrointestinal bleeding in children

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