J.Jpn. Surg. Soc.. 90(9): 1556-1558, 1989
Report on the annual meeting
GASTROINTESTINAL BLEEDING IN CHILDREN
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Department of Surgery, Tokai University, School of Medicine, Isehara, Japan Seishichi Yokoyama, Jinichi Soeda, Takao Fujimoto, Toshio Mitomi |
The differential diagnosis was possible based upon the character of the bleeding and the age of the patient.
Upper endoscopy is the diagnostic maneuver of choice in evaluating the upper gastrointestinal bleeders. Sigmoidoscopy, colonoscopy, technetium scans, tagged red cell scans and intraoperative angiography were helpful in locating bleeding sites of lower bleeders.
Common causes of bleeding were as follows : Hemorrhagic disease, necrotizing enterocolitis, and midgut volvulus in neonates ; intussusceptin and internal hernia in infants ; juvenile polyp and infectious diarrhea in children ; duodenal ulcer and ulcerative colitis in adolescents.
Gastro-duodenal ulcers were found in all age groups. One neonate died of indomethacin induced bleeding, however, bleeding from acute ulcer was usually controlled by conservative treatments.
Increasing frequency of variceal bleeding due to portal hypertensin after successful Kasai procedure for congenital biliary atresia was emphasized.
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