Gastrointestinal Hemorrhage

Abstract

Gastrointestinal (GI) bleeding is a commonly encountered problem in children, with increasing incidence reported in the last decade. Most GI bleeding episodes in children will resolve spontaneously or with medical therapy; only a small percentage require therapeutic endoscopic intervention. The evaluation of a child with GI bleeding begins with a targeted and thorough history and physical exam. The clinician must determine the most likely etiology and the anatomic location of the bleeding to proceed effectively. The various diagnostic studies used in this setting, and preendoscopic preparation, are reviewed in detail. The readily available and emerging endoscopic therapies including injection, thermal, mechanical, and topical modalities are discussed. An expanded differential diagnosis based on the patient’s age is provided with tips to consider when the etiology of GI bleeding remains elusive.