بررسي علل هماتز كودكان در مدت 15 سال در بيمارستان قايم (عج ) مشهد

ETIOLOGICAL EVALUATION OF HEMATEMESIS IN CHILDREN DURING A 15 YEAR PERIOD IN MASHHAD HAEM(Aj) HOSPITAL

Acute upper gastrointestinal bleeding is one of the emergencies in children. Initial management of these patients is hemodynamic stabilization followed by gastric lavage with normal saline which are necessary. After the general condition has been stabilized, endoscopy is the best modality to diagnose the etiology of bleeding during the first 48 hours. In this 15 years study conducted at pediatric endoscopic ward, Ghaem(Aj) Hospital, out of 1168 pediatric gastroscopy files, 195 cases of hematemesis who reported as emergency cases were selected and the cause of hematemesis in these patients was evaluated. The patients ranged from I month to 15 years (mean age 6.9 years) and 56.9% were boys and 43.1% being girls. The most common cause of upper gastrointestinal bleeding in our patients was gastoitis or duodenitis with erosion which was seen in 81(41.5%) of the patients seen. Other causes included esophageal varices (28.7%). In 6.1% of patients, endoscopy was normal. Esophageal ulcer was seen in 2% of patients and rare causes such as duplication in one patient, brachyesophagus (1 patient), Mallory weirs tear (1 patient) and posttonsillectomy bleeding (1 patient) could be seen. Compared to the foreizn literature which report ulcer and varices as the common causes, our findingʹs were comparable to them. The most cause of acute ulcer has been reported to be due to aspirin ingestion and in 25 out of 81 cases suffering from acute ulcer gave a history of aspirin ingestion. In cases of esophageal varices, sclerotherapy was performed during endoscopy if needed, and in patients with ulcer and esophagitis, appropriate treatment was conducted.