Neonatal lower gastrointestinal bleeding

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Background

Mortality from acute GIB in children is low with rectal bleeding in infancy often self-limited condition

Clinical Features

  • blood stool
  • hemodynamic instability if emergent and not minimal bleeding

Differential Diagnosis

  • Other conditions
    • Swallowed maternal blood
      • Apt test :qualitative test using alkali to detect maternal hemoglobin, fetal hgb resistant to alkali stays pink, adult hgb hydrolyzed by alkali turn yellow brown
    • Milk protein entercolitis
    • Perianal/rectal fissure

Evaluation

  • hemodynamically stable treat for shock
  • examine stool directly and test for blood
  • abnormal abdominal exam (distension, tenderness, abnormal bowel sounds) abdominal plain film

Management

  • emergent conditions don't typically present with only hematochezia
  • milk or soy protein induced colitis are well appearing, stools with low-moderate blood, trial eliminating milk and soy from the diet

Disposition

  • depending on etiology

See Also

External Links

References

https://pedemmorsels.com/neonate-with-bloody-stool/ https://www.uptodate.com/contents/lower-gastrointestinal-bleeding-in-children-causes-and-diagnostic-approach


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