Current status and future challenges in the endoscopic management of non-variceal upper gastrointestinal bleeding in children
| Autor: | Wataru Kudou, Katsunori Kouchi, Aki Matsuoka, Kiyoaki Yabe, Ayako Takenouchi, Chikako Nakata |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Adolescent Pediatric surgery medicine Humans Endoscopy Digestive System Retrospective Studies medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Medical record Hemostasis Endoscopic General Medicine medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Hemostasis Pediatrics Perinatology and Child Health Duodenum Female Upper gastrointestinal bleeding Gastritis medicine.symptom business Gastrointestinal Hemorrhage |
| Zdroj: | Pediatric surgery international. 36(12) |
| ISSN: | 1437-9813 |
| Popis: | This study aimed to elucidate the characteristics of non-variceal upper gastrointestinal bleeding (NVUGIB) in children and the outcomes of endoscopic hemostasis (EH) performed by pediatric surgeons. We retrospectively reviewed the medical records of pediatric patients with NVUGIB who had undergone esophagogastroduodenoscopy (EGD) at our hospital, between December 2006 and March 2020. Thirty-six patients were included. The most common endoscopic diagnosis was gastritis (28%), followed by gastric ulcer (25%) and duodenal ulcer (25%). Thirty patients (83%) had underlying diseases, including a recent viral infection (39%), followed by Helicobacter pylori infection (14%). Fourteen patients (39%) underwent EH, exhibiting a high initial rate of hemostasis (100%). This was achieved in 12/14 patients by clipping. One patient was treated using a combination of a hypersaline and epinephrine (HSE) injection and coagulation therapy, as the ulcer exceeded the width of the hemoclips. Rebleeding occurred in one patient (7.1%) initially treated with pure ethanol injections. The partial view of the pediatric duodenum prevented the placement of hemoclips; hence, the patient was treated using a combination of HSE and coagulation therapy. Clipping, injection, and/or coagulation therapy can lead to high success rates for hemostasis, considering the anatomical characteristics in a pediatric population. |
| Databáze: | OpenAIRE |
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