Gastrointestinal bleeding (peds): Difference between revisions
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{{ | <languages/> | ||
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{{PediatricPage|gastrointestinal bleeding}} | |||
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==Background== | ==Background== | ||
*4 Questions | *4 Questions | ||
**Is this really blood? | **Is this really blood? | ||
| Line 7: | Line 13: | ||
**Is it a small or large amount | **Is it a small or large amount | ||
**Has this happened before? | **Has this happened before? | ||
==Clinical Features== | ==Clinical Features== | ||
*Blood in stool or vomit | |||
* | |||
==Differential Diagnosis== | |||
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{{Upper GI bleeding peds DDX}} | |||
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===Lower GI Bleeding (peds)=== | |||
*<2mo | |||
**Swallowed maternal blood | |||
**Milk allergy | |||
**[[Special:MyLanguage/Infectious colitis|Infectious colitis]] | |||
**[[Special:MyLanguage/Intussusception|Intussusception]] | |||
**[[Special:MyLanguage/Volvulus|Volvulus]] | |||
**[[Special:MyLanguage/Meckel diverticulum|Meckel diverticulum]] | |||
**[[Special:MyLanguage/Necrotizing enterocolitis|Necrotizing enterocolitis]] | |||
**[[Special:MyLanguage/Vascular malformation|Vascular malformation]] | |||
**[[Special:MyLanguage/Hemorrhagic disease of newborn|Hemorrhagic disease of newborn]] | |||
**[[Special:MyLanguage/Hirschsprung disease|Hirschsprung disease]] | |||
**[[Special:MyLanguage/Congenital duplications|Congenital duplications]] | |||
| | *2mo–2yr | ||
**[[Special:MyLanguage/Anal fissure|Anal fissure]] | |||
| | **[[Special:MyLanguage/Anal fissure|Anal fissure]] | ||
**[[Special:MyLanguage/Gastroenteritis|Gastroenteritis]] | |||
**Milk allergy | |||
**[[Special:MyLanguage/Intussusception|Intussusception]] | |||
**[[Special:MyLanguage/Volvulus|Volvulus]] | |||
**[[Special:MyLanguage/Meckel diverticulum|Meckel diverticulum]] | |||
: | **[[Special:MyLanguage/Hemolytic uremic syndrome|Hemolytic uremic syndrome]] | ||
: | **[[Special:MyLanguage/Henoch-Schönlein purpura|Henoch-Schönlein purpura]] | ||
**Polyps; benign, familial | |||
**[[Special:MyLanguage/Inflammatory bowel disease|Inflammatory bowel disease]] | |||
**GI duplication | |||
**Dieulafoy lesion | |||
:[[ | *>2yr | ||
**[[Special:MyLanguage/Anal fissure|Anal fissure]] | |||
**[[Special:MyLanguage/Anal fissure|Anal fissure]] | |||
**[[Special:MyLanguage/Gastroenteritis|Gastroenteritis]] | |||
**[[Special:MyLanguage/Hemorrhoids|Hemorrhoids]] | |||
**Polyps | |||
**[[Special:MyLanguage/Colitis|Colitis]] (infectious, ischemic) | |||
**[[Special:MyLanguage/Meckel diverticulum|Meckel diverticulum]] | |||
**[[Special:MyLanguage/Intussusception|Intussusception]] | |||
**[[Special:MyLanguage/Hemolytic uremic syndrome|Hemolytic uremic syndrome]] | |||
**[[Special:MyLanguage/Henoch-Schönlein purpura|Henoch-Schönlein purpura]] | |||
**[[Special:MyLanguage/Inflammatory bowel disease|Inflammatory bowel disease]] | |||
**Angiodysplasia | |||
**[[Special:MyLanguage/Celiac disease|Celiac disease]] | |||
**Dieulafoy lesion | |||
**Rectal ulcer syndrome | |||
**[[Special:MyLanguage/Peptic ulcer disease|Peptic ulcer disease]] | |||
==Evaluation== | |||
*CBC | *CBC | ||
*[[NG tube|NG]] lavage | *[[Special:MyLanguage/NG tube|NG]] lavage | ||
**Consider for ''suspected''sig. GI blood loss | **Consider for ''suspected''sig. GI blood loss | ||
**Small child: 12F NG tube; instill 50cc saline | **Small child: 12F NG tube; instill 50cc saline | ||
**Older child: 14-16F NG tube; instill 100-200cc saline | **Older child: 14-16F NG tube; instill 100-200cc saline | ||
**Aspirate after 2-3min | **Aspirate after 2-3min | ||
==Management== | ==Management== | ||
*Contingent on underlying etiology | *Contingent on underlying etiology | ||
==Disposition== | ==Disposition== | ||
==See Also== | ==See Also== | ||
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{{GI bleeding pages}} | {{GI bleeding pages}} | ||
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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== | ||
<references/> | <references/> | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
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Latest revision as of 17:16, 17 January 2026
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
External Links