Spectrum of upper gastrointestinal bleed in children

Aims and Objectives: To study the etiology, occurrence and pattern of upper gastrointestinal haemorrhage and investigations this would aid in the early diagnosis and management of children with upper gastrointestinal haemorrhage. Methods: This study was conducted over two years on 50 children below 12 years of age who presented with upper gastrointestinal bleeding, at a tertiary care hospital. All the cases were analysed by taking a detailed history and examination. An oesophagogastroduodenoscopy was done in indicated cases. The patients were treated according to standard guidelines and were followed up for a period of two year. Bleeding control was assessed during follow up based on check scopy findings. Results: The majority of children who presented with upper gastrointestinal bleedwere in the age group of 6-10 years with male predominance with male to female ratio being 1.3:1. EHPVO was the most common cause. Among 15 cases of EHPVO, 12 required endoscopic interventions, with recurrent bleed in 3 patients (25%). Oesophageal varices were the commonest finding seen on endoscopy. Of the 14 patients (66.6%) who followed for check scopy, 78.5 % showed no bleed on follow up and 21.5% showed small varices not requiring any intervention. The mortality was 26% (13) in patients with UGIB. Patients who had an underlying hepatic failure and septicaemia had higher mortality as compared to other patients. Conclusion: The outcome of children with EHPVO depends on the control of bleeding. Sclerotherapy and banding are effective in long-term variceal bleeding control. EHPVO was associated with better outcome inpatients with UGIB.