NESMOS Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Pediatric Unit, Sant'Andrea University Hospital, Via Di Grottarossa1035-1039, 00189, Rome, Italy.
Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Ital J Pediatr. 2024 Jan 23;50(1):13. doi: 10.1186/s13052-024-01592-2.
Different conditions may underlie gastrointestinal bleeding (GIB) in children. The estimated prevalence of GIB in children is 6.4%, with spontaneous resolution in approximately 80% of cases. Nonetheless, the initial approach plays a pivotal role in determining the prognosis. The priority is the stabilization of hemodynamic status, followed by a systematic diagnostic approach. GIB can originate from either upper or lower gastrointestinal tract, leading to a broad differential diagnosis in infants and children. This includes benign and self-limiting disorders, alongside serious conditions necessitating immediate treatment. We performed a nonsystematic review of the literature, in order to describe the variety of conditions responsible for GIB in pediatric patients and to outline diagnostic pathways according to patients' age, suspected site of bleeding and type of bleeding which can help pediatricians in clinical practice. Diagnostic modalities may include esophagogastroduodenoscopy and colonoscopy, abdominal ultrasonography or computed tomography and, when necessary, magnetic resonance imaging. In this review, we critically assess these procedures, emphasizing their respective advantages and limitations concerning specific clinical scenarios.
不同的情况可能导致儿童出现胃肠道出血（GIB）。据估计，儿童 GIB 的患病率为 6.4%，约 80%的病例可自发缓解。然而，初始治疗方法对于确定预后至关重要。首先要稳定血流动力学状态，然后进行系统的诊断方法。GIB 可源于上消化道或下消化道，导致婴儿和儿童出现广泛的鉴别诊断。这包括良性和自限性疾病，以及需要立即治疗的严重疾病。我们对文献进行了非系统性回顾，以描述导致儿科患者 GIB 的各种情况，并根据患者的年龄、疑似出血部位和出血类型概述诊断途径，这有助于儿科医生在临床实践中进行诊断。诊断方法可能包括食管胃十二指肠镜检查和结肠镜检查、腹部超声检查或计算机断层扫描，必要时还可进行磁共振成像。在本综述中，我们批判性地评估了这些程序，强调了它们在特定临床情况下各自的优点和局限性。
