The Importance of Endoscopy as a Useful Method for Diagnosis of Upper Gastrointestinal Bleeding in Children

Upper gastrointestinal bleeding (UGIB) is recognized as a life-threatening emergency condition among children and parents, which requires prompt assessment. The purpose of this study was to determine the role of upper endoscopy in determining the cause of UGIB in a pediatric population.
In this retrospective study performed at Ali-Ibn-Abi-Taleb hospital, records of all children with UGIB (below 14 years) were evaluated. Subjects with incomplete information were excluded from the study.
A total of 101 patients with the mean ± SD age of 6.8 ± 3.99 years were included in this study (45 females, 56 males). The clinical presentations included hematemesis in 77 (76%) cases, melena in 6 (5.9%) cases, and both in 18 (17.8) cases. The upper endoscopy showed a high diagnostic yield (90%) in determining the cause of UGIB. The most common source of bleeding was esophageal varices in 32 (31.7%) children, followed by peptic ulcer disease (n, 17; 16.8%), gastritis (n, 11; 10.9%), and hiatal hernia. No cause of UGIB was found in 10 (9.9%) cases.
Esophageal varices and peptic ulcer disease were the most common causes of UGIB in our center. Considering the valuable role of endoscopy in the diagnosis and treatment of UGIB, early referral to a hospital with pediatric endoscopy is recommended.