Talib Muhammad Abu, Aziz Muhammad Tariq, Suleman Hassan, Khosa Ghazi Khan, Joya Saima Jabeen, Hussain Ibrar
Muhammad Abu Talib, Department of Pediatric Gastroenterology and Hepatology, Children's Hospital and The Institute of Child's Heath, Multan, Pakistan.
Muhammad Tariq Aziz, Department of Pediatric Gastroenterology and Hepatology, Children's Hospital and The Institute of Child's Heath, Multan, Pakistan.
Pak J Med Sci. 2021 Mar-Apr;37(2):556-560. doi: 10.12669/pjms.37.2.2676.
To determine etiology and outcome of children with lower gastrointestinal bleeding (LGIB).
This was a prospective study conducted at the Department of Pediatric Gastroenterology and Hepatology, Children's Hospital and The Institute of Child's Heath, Multan, Pakistan, from July 2019 to March 2020. A total of 148 cases presented with bleeding per rectum and underwent colonoscopy, were included. Children of both genders and aged three month to 15 years were included. Detailed history, clinical examination, laboratory studies, colonoscopy and histopathology were done in all cases. Study information like demographics, complaints, general clinical examination, colonoscopy and histopathological findings were recorded.
Overall, mean age was noted to be 7.20±1.83 years. Abdominal pain was reported in 41 (27.7%), diarrhea 36 (24.3%), fever 12 (8.1%) and constipation in 4 (2.7%). Pallor was noted among 68 (45.9%), weight loss 39 (26.3%) and tachycardia 31 (20.9%). Colonoscopy revealed juvenile colonic / rectal polyps, infectious colitis and solitary rectal ulcer (SRU) as the most common etiologies found among 58 (39.2%), 20 (13.5%) and 19 (12.8%) cases respectively. Juvenile polyps and non-specific colitis were the commonest histopathological findings seen in 55 (37.2%) and 20 (13.5%) cases respectively. Colonoscopic polypectomy was used to remove all juvenile polyps.
LGIB is presentation of various underlying causes. Children with LGIB commonly present with abdominal pain. Juvenile polyps were the most frequent cause of LGIB among children flowed by non-specific colitis. Most of the children having LGIB were diagnosed and treated successfully, few are in remission and very few were found resistant to treatment.
确定小儿下消化道出血（LGIB）的病因及预后。
这是一项前瞻性研究，于2019年7月至2020年3月在巴基斯坦木尔坦儿童医院及儿童健康研究所小儿胃肠病学和肝病科开展。共有148例出现直肠出血并接受结肠镜检查的病例纳入研究。纳入了年龄在3个月至15岁的男女儿童。所有病例均进行了详细的病史采集、临床检查、实验室检查、结肠镜检查及组织病理学检查。记录了人口统计学信息、主诉、一般临床检查、结肠镜检查及组织病理学检查结果等研究信息。
总体而言，平均年龄为7.20±1.83岁。41例（27.7%）报告有腹痛，36例（24.3%）有腹泻，12例（8.1%）有发热，4例（2.7%）有便秘。68例（45.9%）有面色苍白，39例（26.3%）有体重减轻，31例（20.9%）有心动过速。结肠镜检查发现，青少年结肠/直肠息肉、感染性结肠炎和孤立性直肠溃疡（SRU）分别是58例（39.2%）、20例（13.5%）和19例（12.8%）病例中最常见的病因。青少年息肉和非特异性结肠炎分别是55例（37.2%）和20例（13.5%）病例中最常见的组织病理学发现。采用结肠镜下息肉切除术切除所有青少年息肉。
LGIB是由多种潜在病因引起的。LGIB患儿常表现为腹痛。青少年息肉是儿童LGIB最常见的病因，其次是非特异性结肠炎。大多数LGIB患儿得到了成功诊断和治疗，少数病情缓解，极少数对治疗耐药。
