The upper endoscopy in upper gastrointestinal hemorrhage of children.

ABSTRACT

Between 1992-1994, 20 children aged 3 months to 16 years who were admitted to Department of Pediatrics, Faculty of Medicine, Siriraj Hospital with problems of hematemesis and melena underwent gastrointestinal endoscopy. Thirteen children developed bleeding before admission and underlying diseases in 3 of these were chronic renal failure, pulmonary TB and malignant mesenchymoma. The main causes of hemorrhage in this group were gastritis (5 cases), esophagitis (3 cases) and esophageal varices (2 cases). The underlying disease of 7 children with hemoeehage during hospitalization were blood disease, SLE with renal failure and gastroesophageal reflux. The esophagitis, candida esophagitis, and gastric esosion were the etiologies of bleeding. Nine children needed blood transfusion and one had further investigations including meckel scan, tagged red cell scan and colonoscopy. Four patients died due to sepsis. The endoscopy had the value of establishing the etiology of upper gastrointestinal hemorrhage in 19 cases.