Gastrointestinal bleeding (peds): Difference between revisions
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{{Peds top}} [[gastrointestinal bleeding]]
<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?
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**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==
==Differential Diagnosis==
===Upper GI Bleeding===
 
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{{Upper GI bleeding peds DDX}}
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===Lower GI Bleeding (peds)===
 
*<2mo
*<2mo
**Swallowed maternal blood (from chapped nipples)
**Swallowed maternal blood
**[[gastric ulcer disease|Stress ulcer]]
**Milk allergy
**Vascular malformation
**[[Special:MyLanguage/Infectious colitis|Infectious colitis]]
**Hemorrhagic disease of newborn ([[vitamin K deficiency]])
**[[Special:MyLanguage/Intussusception|Intussusception]]
**[[Coagulopathy]]/bleeding diathesis
**[[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
*2mo–2yr
**[[Acute gastroenteritis (peds)|Gastroenteritis]]
**[[Special:MyLanguage/Anal fissure|Anal fissure]]
**[[Toxic ingestion]]
**[[Special:MyLanguage/Anal fissure|Anal fissure]]
**[[Mallory-Weiss tear]]
**[[Special:MyLanguage/Gastroenteritis|Gastroenteritis]]
**Vascular malformation
**Milk allergy
**[[Esophagitis]]
**[[Special:MyLanguage/Intussusception|Intussusception]]
**[[gastric ulcer disease|Stress ulcer]]
**[[Special:MyLanguage/Volvulus|Volvulus]]
**[[Coagulopathy]]/bleeding diathesis
**[[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
**GI duplication
**[[Ingested foreign body]]
**Dieulafoy lesion
 
*>2yr
*>2yr
**[[Acute gastroenteritis (peds)|Gastroenteritis]]
**[[Special:MyLanguage/Anal fissure|Anal fissure]]
**[[Mallory-Weiss tear]]
**[[Special:MyLanguage/Anal fissure|Anal fissure]]
**[[Peptic ulcer disease]]
**[[Special:MyLanguage/Gastroenteritis|Gastroenteritis]]
**[[Toxic ingestion]]
**[[Special:MyLanguage/Hemorrhoids|Hemorrhoids]]
**Vascular malformation
**Polyps
**[[Gastritis]]
**[[Special:MyLanguage/Colitis|Colitis]] (infectious, ischemic)
**[[Varices]]
**[[Special:MyLanguage/Meckel diverticulum|Meckel diverticulum]]
**Hemobilia
**[[Special:MyLanguage/Intussusception|Intussusception]]
**[[Ingested foreign body]]
**[[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]]


===Lower GI Bleeding (peds)===
{| {{table}}
| align="center" style="background:#f0f0f0;"|'''<2 Mo'''
| align="center" style="background:#f0f0f0;"|'''2 Mo–2 Y'''
| align="center" style="background:#f0f0f0;"|'''>2 Y'''
|-
|
*Swallowed maternal blood
*Milk allergy
*[[Infectious colitis]]
*[[Intussusception]]
*[[Volvulus]]
*[[Meckel diverticulum]]
*[[Necrotizing enterocolitis]]
*[[Vascular malformation]]
*[[Hemorrhagic disease of newborn]]
*[[Hirschsprung disease]]
*[[Congenital duplications]]
||
*[[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
||
*[[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==
==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==
</translate>
{{GI bleeding pages}}
{{GI bleeding pages}}
<translate>


==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]


==Video==
{{#widget:YouTube|id=RW0qAo4mYks}}


==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)


Lower GI Bleeding (peds)


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


External Links


References

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