Document Detail

Management of Gastrointestinal Bleeding in Children.
MedLine Citation:
PMID:  12207863     Owner:  NLM     Status:  Publisher    
Gastrointestinal bleeding in infants and children is a potentially life-threatening problem that is encountered by virtually all practicing pediatric gastroenterologists. Youngsters with a normal hematocrit, hemodynamic stability, and a history consistent with an acute, self-limited illness most frequently need only close observation; others require more in-depth assessment and intervention. Meticulous attention to the patient's cardiopulmonary status and knowledge of appropriate pediatric resuscitation schemes form the cornerstones on which more specific therapeutic interventions are based. Many treatment techniques and approaches have been extrapolated for pediatric use from adult studies; the regimen implemented for a child should be individualized and based on factors such as patient size, underlying condition, and operator expertise. Although the physician treating pediatric gastrointestinal hemorrhage requires more than a modicum of patience and determination, this must be tempered with a ready willingness to seek consultation from surgical colleagues to ensure optimal outcomes. Knowledge of acid-suppressive and vasoactive medications is essential, as is familiarity with at least one injection technique and one thermocoagulation technique for hemostasis. Endoscopic sclerotherapy and variceal band ligation are equally efficacious in achieving control of acute variceal bleeding, but band ligation is emerging as the technique best suited for prophylaxis. Beta blockade appears to have a smaller and less well-defined role in pediatric variceal prophylaxis compared with that in adults, but random controlled trials are necessary to confirm this impression.
John M. Peters
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Publication Detail:
Journal Detail:
Title:  Current treatment options in gastroenterology     Volume:  5     ISSN:  1534-309X     ISO Abbreviation:  Curr Treat Options Gastroenterol     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-Sep-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815941     Medline TA:  Curr Treat Options Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  399-413     Citation Subset:  -    
Division of Pediatric Gastroenterology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA.
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