Gastrointestinal bleeding (peds): Difference between revisions

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==Differential Diagnosis==
==Differential Diagnosis==
===Upper GI Bleeding===
===Upper GI Bleeding (peds)===
*<2mo
*<2mo
**Swallowed maternal blood (from chapped nipples)
**Swallowed maternal blood (from chapped nipples)
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===Lower GI Bleeding (peds)===
===Lower GI Bleeding (peds)===
{| {{table}}
*<2mo
| align="center" style="background:#f0f0f0;"|'''<2 Mo'''
**Swallowed maternal blood
| align="center" style="background:#f0f0f0;"|'''2 Mo–2 Y'''
**Milk allergy
| align="center" style="background:#f0f0f0;"|'''>2 Y'''
**[[Infectious colitis]]
|-
**[[Intussusception]]
|
**[[Volvulus]]
*Swallowed maternal blood
**[[Meckel diverticulum]]
*Milk allergy
**[[Necrotizing enterocolitis]]
*[[Infectious colitis]]
**[[Vascular malformation]]
*[[Intussusception]]
**[[Hemorrhagic disease of newborn]]
*[[Volvulus]]
**[[Hirschsprung disease]]
*[[Meckel diverticulum]]
**[[Congenital duplications]]
*[[Necrotizing enterocolitis]]
 
*[[Vascular malformation]]
*2mo–2yr
*[[Hemorrhagic disease of newborn]]
**[[Anal fissure]]
*[[Hirschsprung disease]]
**[[Anal fissure]]
*[[Congenital duplications]]
**[[Gastroenteritis]]
||
**Milk allergy
*[[Anal fissure]]
**[[Intussusception]]
*[[Anal fissure]]
**[[Volvulus]]
*[[Gastroenteritis]]
**[[Meckel diverticulum]]
*Milk allergy
**[[Hemolytic uremic syndrome]]
*[[Intussusception]]
**[[Henoch-Schönlein purpura]]
*[[Volvulus]]
**Polyps; benign, familial
*[[Meckel diverticulum]]
**[[Inflammatory bowel disease]]
*[[Hemolytic uremic syndrome]]
**GI duplication
*[[Henoch-Schönlein purpura]]
**Dieulafoy lesion
*Polyps; benign, familial
*>2yr
*[[Inflammatory bowel disease]]
**[[Anal fissure]]
*GI duplication
**[[Anal fissure]]
*Dieulafoy lesion
**[[Gastroenteritis]]
||
**[[Hemorrhoids]]
*[[Anal fissure]]
**Polyps
*[[Anal fissure]]
**[[Colitis]] (infectious, ischemic)
*[[Gastroenteritis]]
**[[Meckel diverticulum]]
*[[Hemorrhoids]]
**[[Intussusception]]
*Polyps
**[[Hemolytic uremic syndrome]]
*[[Colitis]] (infectious, ischemic)
**[[Henoch-Schönlein purpura]]
*[[Meckel diverticulum]]
**[[Inflammatory bowel disease]]
*[[Intussusception]]
**Angiodysplasia
*[[Hemolytic uremic syndrome]]
**[[Celiac disease]]
*[[Henoch-Schönlein purpura]]
**Dieulafoy lesion
*[[Inflammatory bowel disease]]
**Rectal ulcer syndrome
*Angiodysplasia
**[[Peptic ulcer disease]]
*[[Celiac disease]]
*Dieulafoy lesion
*Rectal ulcer syndrome
*[[Peptic ulcer disease]]
|}


==Evaluation==
==Evaluation==

Revision as of 23:04, 29 March 2022

This page is for pediatric patients. For adult patients, see: gastrointestinal bleeding

Background

  • 4 Questions
    • Is this really blood?
    • Is blood really coming from the GI tract?
      • Blood in diaper may also be vaginal or urinary source
    • Is it a small or large amount
    • Has this happened before?

Clinical Features

Differential Diagnosis

Upper GI Bleeding (peds)

Lower GI Bleeding (peds)

Evaluation

  • CBC
  • NG lavage
    • Consider for suspectedsig. GI blood loss
    • Small child: 12F NG tube; instill 50cc saline
    • Older child: 14-16F NG tube; instill 100-200cc saline
    • Aspirate after 2-3min

Management

  • Contingent on underlying etiology

Disposition

See Also

Gastrointestinal Bleeding Pages

External Links

Video

References