Gastrointestinal bleeding (peds): Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Blood in stool or vomit | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Upper GI bleeding peds DDX}} | |||
===Lower GI Bleeding (peds)=== | ===Lower GI Bleeding (peds)=== | ||
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==External Links== | ==External Links== | ||
*[http://pemplaybook.org/podcast/gi-bleeding-in-children/ Pediatric Emergency Playbook Podcast: GI Bleeding in Children] | *[http://pemplaybook.org/podcast/gi-bleeding-in-children/ Pediatric Emergency Playbook Podcast: GI Bleeding in Children] | ||
==References== | ==References== | ||
Latest revision as of 15:44, 10 April 2024
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
- Blood in stool or vomit
Differential Diagnosis
Upper GI Bleeding (peds)
- <2mo
- Swallowed maternal blood (from chapped nipples)
- Stress ulcer
- Vascular malformation
- Hemorrhagic disease of newborn (vitamin K deficiency)
- Coagulopathy/bleeding diathesis
- 2mo–2yr
- Gastroenteritis
- Toxic ingestion
- Mallory-Weiss tear
- Vascular malformation
- Esophagitis
- Stress ulcer
- Coagulopathy/bleeding diathesis
- GI duplication
- Ingested foreign body
- >2yr
- Gastroenteritis
- Mallory-Weiss tear
- Peptic ulcer disease
- Toxic ingestion
- Vascular malformation
- Gastritis
- Varices
- Hemobilia
- Ingested foreign body
Lower GI Bleeding (peds)
- <2mo
- Swallowed maternal blood
- Milk allergy
- Infectious colitis
- Intussusception
- Volvulus
- Meckel diverticulum
- Necrotizing enterocolitis
- Vascular malformation
- Hemorrhagic disease of newborn
- Hirschsprung disease
- Congenital duplications
- 2mo–2yr
- Anal fissure
- Anal fissure
- Gastroenteritis
- Milk allergy
- Intussusception
- Volvulus
- Meckel diverticulum
- Hemolytic uremic syndrome
- Henoch-Schönlein purpura
- Polyps; benign, familial
- Inflammatory bowel disease
- GI duplication
- Dieulafoy lesion
- >2yr
- Anal fissure
- Anal fissure
- Gastroenteritis
- Hemorrhoids
- Polyps
- Colitis (infectious, ischemic)
- Meckel diverticulum
- Intussusception
- Hemolytic uremic syndrome
- Henoch-Schönlein purpura
- Inflammatory bowel disease
- Angiodysplasia
- Celiac disease
- Dieulafoy lesion
- Rectal ulcer syndrome
- Peptic ulcer disease
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
- Adults
- Pediatrics