J Am Board Fam Med. 2015 Jan-Feb;28(1):134-45. doi: 10.3122/jabfm.2015.01.140153.

Diagnosis and management of upper gastrointestinal bleeding in children.

Journal of the American Board of Family Medicine : JABFM

Susan Owensby, Kellee Taylor, Thad Wilkins

PMID: 25567834 DOI: 10.3122/jabfm.2015.01.140153

Abstract

Upper gastrointestinal bleeding is an uncommon but potentially serious, life-threatening condition in children. Rapid assessment, stabilization, and resuscitation should precede all diagnostic modalities in unstable children. The diagnostic approach includes history, examination, laboratory evaluation, endoscopic procedures, and imaging studies. The clinician needs to determine carefully whether any blood or possible blood reported by a child or adult represents true upper gastrointestinal bleeding because most children with true upper gastrointestinal bleeding require admission to a pediatric intensive care unit. After the diagnosis is established, the physician should start a proton pump inhibitor or histamine 2 receptor antagonist in children with upper gastrointestinal bleeding. Consideration should also be given to the initiation of vasoactive drugs in all children in whom variceal bleeding is suspected. An endoscopy should be performed once the child is hemodynamically stable.

© Copyright 2015 by the American Board of Family Medicine.

Keywords: Gastrointestinal Hemorrhage; Pediatrics

MeSH terms

• Child
• Diagnosis, Differential
• Gastrointestinal Hemorrhage / diagnosis
• Gastrointestinal Hemorrhage / epidemiology
• Gastrointestinal Hemorrhage / etiology
• Gastrointestinal Hemorrhage / therapy
• Humans
• Physical Examination
• Risk Factors

Publication Types

• Journal Article
• Review