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

Moravej, Hossein; Dehghani, Seyed Mohsen; Nikzadeh, Hamideh; Malekpour, Abdorrasoul

doi:10.17795/compreped-8423

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…Polyps were more common in <5 years age group (48.1%) than other pathology and that was statistically significant. Begum et al 23 & Alam et al 35 from Bangladesh, Deeb et al 28 from Egypt and Moravej et al 36 from Iran also found the similar results.…”

Section: Discussionsupporting

confidence: 56%

Spectrum of Colonoscopy in Children: A Tertiary Centre Experience from Bangladesh

Mahmud

Parvez

Baidya

et al. 2023

Dhaka Shishu (Child) Hosp. J.

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Background: Pediatric colonoscopy is a safe, sensitive and crucial tool for diagnosing as well as treating children with lower gastrointestinal diseases. In resource-limited countries like Bangladesh, the practice of pediatric colonoscopy remains rudimentary, lacking in trained professionals and appropriate instrumentation. Objectives: The aim of the study was to find out the indications, common colonoscopic findings along with histopathologic evaluation and immediate post procedure complications of colonoscopy in children. Methods: This was a retrospective study; the records of all the patients whose age was less than 18 years and who underwent colonoscopy from January 2017 to December 2021 were studied. Results: Among the total of 196 children (8.23±4.12), the most common indications were lower gastrointestinal bleeding (LGIB) in 107 (54.6%) patients followed by chronic diarrhea in 33 (16.8%), recurrent abdominal pain (RAP) in 16 (8.2%), follow up Inflammatory bowel diseases (IBD) in 14 (7.1%), chronic constipation, weight loss, recurrent oral ulcer, intestinal tuberculosis (TB) and melena. The most common pathologic findings were polyps in 81 (61.4%) children followed by non-specific colitis in 19 (14.4%), IBD in 17 (12.9%) and infectious colitis in 09 (6.8%) cases. Minor adverse events occurred in only 2.0% of children. Conclusion: The commonest indication for pediatric colonoscopy was LGIB and the most common findings were colonic polyps. Pediatric colonoscopy is safe and effective diagnostic as well as therapeutic option for lower GI diseases. DS (Child) H J 2021; 38(1): 8-16

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Section: Discussionsupporting

confidence: 56%

Spectrum of Colonoscopy in Children: A Tertiary Centre Experience from Bangladesh

Mahmud

Parvez

Baidya

et al. 2023

Dhaka Shishu (Child) Hosp. J.

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“…Our finding (7%) is in close agreement with previous studies showing similar proportions of patients with LGIB being subsequently diagnosed as IBD by Panda et al (6.5%) 19 and Moravej et al (6.47%). 15 We did not encounter lymphoid nodular hyperplasia (NLH) as a cause of LGIB as described by Panda et al 19 NLH is a vague entity and often an incidental finding in colonoscopy and encountered more in children in the first decade. The highly variable prevalence of NLH is often attributed to underreporting in colonoscopy.…”

Section: Discussionmentioning

confidence: 73%

“…Normal colonoscopy was found in a variable proportion of patients in different studies. 12 14 15 Normal colonoscopy could be attributed to several etiologies including lesion hidden behind mucosal folds, etiology in the small bowel that resolved by itself, and missed lesions due to poor preparation or ulcers that healed itself before the procedure was performed. These lacunae can be addressed by relook procedures in case of recurrence of overt or occult GI bleed being subjected to relook colonoscopic procedures.…”

Section: Discussionmentioning

confidence: 99%

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Lower Gastrointestinal Bleed in Children: Safety, Utility, and Yield of Colonoscopy: an Experience from a Large Tertiary Referral Endoscopy Center

Irtaza,

Sundaram,

Gopan

et al. 2024

Journal of Digestive Endoscopy

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Objective: There is paucity of data on lower gastrointestinal bleed (LGIB) in the pediatric population. We aimed to retrospectively review the endoscopy findings in patients younger than 18 years, presenting with lower gastrointestinal (GI) bleed and undergoing colonoscopy. Materials and Methods: Retrospective review of the endoscopy database at the department of gastroenterology at a tertiary care center from Western India was conducted between June 2017 until December 2021. Patients ≤18 years with LGIB, who underwent colonoscopy within 7 days of onset of bleed, were included in the study. Demographic details, endoscopic findings, and complications were noted. Results: In all, 55 patients were included in study (65% males; median age: 13 years [range: 1–18 years]). The most common endoscopic findings were polyps in 26 (47.2%) patients, colitis in 15 (27.2%) patients, solitary rectal ulcer syndrome (SRUS) in 6 (11.3%) patients, and hemorrhoids in 3 (5.4%) patients. Five (9%) patients had normal colonoscopy in whom the cause remained unidentified on further evaluation. However, no repeat episode was documented on a follow-up of 30 days. The most common location of a polyp was the rectum (64%). Two patients had multiple polyps (2 each). All the patients underwent a successful polypectomy. Pathology reported juvenile polyps in 25 biopsies. Four were diagnosed as inflammatory bowel disease (IBD), while 11 had acute infective colitis. Patients with infectious colitis as compared to IBD had higher incidence of fever (55 vs. 0%) and lesser incidence of previous similar events (22 vs. 66%). Those with polyps were younger than those without polyps (9.1 vs. 14.3 years; p = 0.000). Polyps were significantly more common in boys (84%; 22/26; p = 0.014) than in girls. No complications occurred in this cohort of patients. Conclusions: Polyps are the most common cause of LGIB in patients ≤18 years, followed by colitis. Polyps were more common in younger males.

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“…IBD is a commonly encountered disease in patients with lower GI bleeding. In an Iranian study, IBD was detected in 20 (6.5%) of 309 children with rectal bleeding (15). The mean age of Iranian patients with IBD was 10.3 years in another Iranian study (16).…”

Section: Discussionmentioning

confidence: 95%

A survey on rectal bleeding in children, a report from Iran

2018

Turk J Med Sci

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Background/aim: Studies on the epidemiology of rectal bleeding in children are limited in Iran. Our aim was to assess etiologies of rectal bleeding in children in Iran. Materials and methods:We enrolled 730 children with rectal bleeding. All the patients underwent colonoscopy, and 457 were further evaluated with histopathology.Results: According to colonoscopy and histopathology, respectively, inflammatory bowel disease (IBD) (29.4%, 15.8%), nodular hyperplasia (NH) (24.9%, 10%), and juvenile polyposis (JP) (12.6%, 9.9%) were the most common causes of rectal bleeding. Other conditions were solitary rectal ulcer (5.3%), chronic colitis (4.6%), allergic colitis (3.3%), focal colitis (1.3%), and infectious colitis (1.1%). In colonoscopy, there were no significant differences in the distribution of pathologies regarding sex, while the youngest and oldest mean ages were found for patients with NH (4.6 ± 3.9 years, P < 0.0001) and those with normal appearance (8.1 ± 4.4 years, P < 0.0001) respectively. Based on histopathologic reports, the youngest patients were diagnosed with infectious colitis (4.6 ± 2.8 years), while patients with chronic colitis were the oldest (9.2 ± 4.6 years, P = 0.003). Conclusion:JP, NH, and IBD constituted the most common etiologies of rectal bleeding in our patients. It is recommended to perform a complete diagnostic approach to accurately assess rectal bleeding in children.

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

Cited by 6 publications

References 21 publications

Spectrum of Colonoscopy in Children: A Tertiary Centre Experience from Bangladesh

Spectrum of Colonoscopy in Children: A Tertiary Centre Experience from Bangladesh

Lower Gastrointestinal Bleed in Children: Safety, Utility, and Yield of Colonoscopy: an Experience from a Large Tertiary Referral Endoscopy Center

A survey on rectal bleeding in children, a report from Iran

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