Gastrointestinal bleeding (peds): Difference between revisions
| Line 11: | Line 11: | ||
==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) | ||
| Line 42: | Line 42: | ||
===Lower GI Bleeding (peds)=== | ===Lower GI Bleeding (peds)=== | ||
*<2mo | |||
**Swallowed maternal blood | |||
**Milk allergy | |||
**[[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)
- <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
External Links
Video
{{#widget:YouTube|id=RW0qAo4mYks}}
