tailieunhanh - Practical Pediatric Gastrointestinal Endoscopy - part 5

Thấp GI xuất huyết hoại tử ruột Midgut volvulus Anal nứt Hirschsprung của dị tật bệnh mạch máu proctitis Anal nứt dị ứng hoặc viêm ruột nốt bạch huyết tăng sản lồng ruột Anal vết nứt lồng ruột Meckel của tăng sản diverticulum polyp nốt lymphoid truyền nhiễm viêm đại tràng tán huyết urê huyết hội chứng Henoch-Schonlein ban xuất huyết truyền nhiễm viêm đại tràng loét viêm đại tràng | 80 CHAPTER 5 Age Upper GI bleeding Low GI bleeding Neonates 0-30 days Swallowed maternal blood Hemorrhagic disease of the newborn Stress ulcers sepsis Hemorrhagic gastritis Necrotizing enterocolitis Midgut volvulus Anal fissure Hirschsprung s disease Vascular malformation Infants 30 days to 6 mo Cow milk or soy-protein allergy Esophagitis Mallory-Weiss tear Portal hypertension Anal fissure Allergic proctitis or enterocolitis Nodular lymphoid hyperplasia Intussusception Infants and children 6 mo to 6 yr Epistaxis Esophagitis Portal hypertension Drug-induced ulcers Gastritis Anal fissures Intussusception Meckel s diverticulum Nodular lymphoid hyperplasia Polyps Infectious colitis Hemolytic uremic syndrome Henoch-Schonlein purpura Children and teenagers 7-18 yr Epistaxis Drug-induced gastropathy and ulcers Peptic ulcer Esophagitis Gastritis Portal hypertension Crohn s disease Infectious colitis Ulcerative colitis Crohn s disease Polyps Polyposis Hemorrhoids Table Common causes of GI bleeding in children. In neonates the most common endoscopic findings are gastritis alone or in combination with esophagitis and or secondary gastric or duodenal ulcers due to neonatal stress sepsis or hypoxia. The other possible but rare cause of hematemesis in neonates is cow s milk intolerance. In infants and young children the spectrum of diseases causing hematemesis or melena is broader acute drug-induced gastritis or duodenitis a variety of secondary ulcerations due to sepsis or increased intracranial pressure and stress from major surgery reflex esophagitis Mallory-Weiss tear esophageal varices opportunistic infections in immunocompromised patients etc. The frequency of aspirin-induced gastric and duodenal lesions in children is substantially less now than in the past. However they still do happen because many over-the-counter cold medications contain salicylates. Nonsteroidal anti-inflammatory NSAID drugs may also cause gastritis and ulcers. Two types of lesions are often .