GI/Upper Gastrointestinal Bleed-Etiology,Management,Guidelines for Management

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Gastrointestinal Disorders in Children

Upper Gastrointestinal bleed

Gastrointestinal Disorders in Children

Zinc and ORS

Acute Diarrhea in Children

Inflammatory Bowel Disease/IBD

Acute Childhood Diarrhea: Review of Recent Advances in Standard Management

Zinc For The Prevention Of Diarrhea

Oral Rehydration Therapy

Approach To Acute Abdominal Pain In Children

Trachea oesophageal fistula

Vomiting and Diarrhea in Children

Upper Gastrointestinal bleed

ORS - Which one to use?

Acute Abdomen

Malabsorption syndromes

Prevention of Diarrhea

Lactose Intolerance in Infants, Children, and Adolescents

Biliary Atresia and Kasai's Surgery - When is it too Late

Clinical Tools

Clinical Vignettes

Diseases & Conditions

Drugs Interaction Calculator

Podcasts

Patient Management Online

Diagnostic Dilemma

Question of the Day

Diagnostic Aid

VACCINE REMINDER

"Get the Vaccine Schedule for your child."

Ask Queries

SPECIALIST ANSWERS

Today's Poll

Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

Vote

Results

UPPER GASTROINTESTINAL BLEED

Dr. Swati Gadewar (Kolpuru)
DCH

This is one of the very few conditions, which scares the child and the parents and at the same time poses a challenge to the physician to diagnose the cause for it. Upper GI bleeding refers to bleeding above the ligament of Treitz.

ETIOLOGY

Peptic ulcer

Gastritis

Esophagitis

Mallory-Weiss tear

Varices

Vascular malformation

Toxic ingestion

Foreign body irritation

Hemorrhagic gastritis

Bleeding diathesis

Medications

MANAGEMENT OF SEVERE UPPER GI BLEEDING

Management depends on the severity and quantity of bleeding.

Significant blood loss is indicated by

Pallor

Tachycardia

Orthostatic Hypotension

Restlessness

Confusion

Poor capillary refill

GUIDELINES FOR MANAGEMENT

Priority is airway, breathing and circulation.

A cuffed endotracheal tube can prevent aspiration in case of severe bleeding

The next step is to pass a large bore IV cannula and simultaneously blood should be withdrawn for blood grouping and cross-matching, CBC, Platelet count, PT and PTT.

Fluid resuscitation should be carried out with normal saline or ringer lactate in 10-20ml/kg boluses and may be repeated.

Pass a nasogastric tube. Lavage can be done using normal saline or water. The volume used depends on age of the patient.: 50 ml for infants, 100 to 200 ml for children.

Blood should be given to the patient if they remain in shock.

Platelets, Vitamin K, fresh frozen plasma should be given depending on the underlying cause.

If the bleeding stops, endoscopy should be done to determine the cause of bleeding and also the risk of recurrence. Endoscopy can also help in the therapy in the same session.

If peptic ulcer is the cause of bleeding, patients at high risk for rebleeding should undergo therapy, which consists of endoscopic ablation of ulcer base and coagulation of visible vessels at the ulcer base or margin. If the risk for rebleeding is low patients should be managed medically. IV ranitidine or cemetidine can be used.

If the cause for the bleed is variceal haemorrhage and the bleeding fails to stop, vasopressin infusion must be started cautiously at a rate of 0.3 U/Kg diluted in 5ml/kg of D5W given over 20 minutes followed by a continuous infusion of 0.2 to 0.4U/1.73 m²/min. Balloon tamponade and endoscopic therapy should be considered if bleeding not controlled.

Last created on 23-02-2001
Last updated on 11-05-2007

Mail To Your Friend

Print This Article

TOP SEARCH TERMS

ORT and ORS

Fluid therapy in diarrhoea

IBD Causes

Oral Rehydration Solution

Diet and Zinc

Pathophysiology of diarrhea

Red Flag Signs for Acute Abdominal Pain

Trachea oesophageal fistula Classifications

Vomiting and diarrhea treatment

Guidelines for Upper Gastrointestinal bleed

Choice of ORS

Acute abdomen Causes

Malabsorption principles of management

Diarrhea prevention steps

Lactase Deficiency

Diseases & Conditions

Pediatric Oncall Journal

Pediatric Conferences

Ped Tools

Adverse Drug Reactions

Pediatric oncall book store

Partner Sites

Infection in Children

Pedcall

Medical ADRIS

Vaccine Reminder

Pediatric Oncall Journal

Educational Section

Disclaimer:

The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitute an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

Sitemap For Doctor

Sitemap For Parent

Sitemap For Kids