Upper gastrointestinal bleeding: etiology and management

Indian Journal of Pediatrics
N K AroraA Patwari

Abstract

Upper gastrointestinal bleeding is a potentially fatal condition at times due to loss of large volumes of blood. Common sources of upper gastrointestinal bleeding in children include mucosal lesions and variceal hemorrhage (most commonly extra hepatic portal venous obstruction) and, in intensive care settings infections and drugs are other etiological factors associated with bleeding. Massive upper GI bleeding is life threatening and requires immediate resuscitation measures in the form of protection of the airways, oxygen administration, immediate volume replacement with ringer lactate or normal saline, transfusion of whole blood or packed cells and also monitoring the adequacy of volume replacement by central venous lines and urine output. Upper GI endoscopy is an effective initial diagnostic modality to localize the site and cause of bleeding in almost 85-90% of patients. Antacids supplemented by H2- receptor antagonists, proton pump inhibitors and sucralfate are the mainstay in the treatment of bleeding from mucosal lesion. For variceal bleeds, emergency endoscopy is the treatment of choice after initial haemodynamic stabilization of patient. If facilities for endoscopic sclerotherapy (EST) are not available, pharmacotherap...Continue Reading

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Citations

Apr 25, 2009·Indian Journal of Pediatrics·Seyed Mohsen DehghaniMahmood Reza Tabebordbar
Nov 12, 2009·Indian Journal of Pediatrics·Derya KalyoncuFeyzullah Cetinkaya
May 18, 2012·Pakistan Journal of Biological Sciences : PJBS·E FattahiR F Fouladi
Dec 15, 2010·Indian Journal of Pediatrics·Vidyut Bhatia, Rakesh Lodha
Dec 2, 2010·Journal of Zhejiang University. Science. B·Hong-ying LiuZhi-yu Wen
Nov 14, 2015·World Journal of Clinical Pediatrics·Abdulkerim Temiz
May 20, 2016·The Cochrane Database of Systematic Reviews·Shuang-Hong LuoChaomin Wan
Nov 24, 2011·Journal of Pediatric Gastroenterology and Nutrition·Stephen B FreedmanJennifer D Thull-Freedman
Mar 11, 2015·European Journal of Pediatric Surgery Reports·Mutlu Uysal YaziciIlhan Tezcan

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