title: The BUN/creatinine ratio in localizing gastrointestinal bleeding in pediatric patients.
abstract: Localizing the bleeding site in pediatric patients with gastrointestinal hemorrhage may require invasive and costly diagnostic procedures. A simple index to discriminate upper and lower bleeding sources would be invaluable. We evaluated the reliability of the calculated blood urea nitrogen/creatinine (BUN/Cr) ratio in segregating upper from lower gastrointestinal bleeding sites in 40 children. For upper gastrointestinal hemorrhage, the calculated BUN/Cr ratios (mg/mg) ranged from 10 to 140, with a mean value of 34. For lower gastrointestinal bleeders, the BUN/Cr ratios ranged from 3.3 to 30, with a mean value of 16. All BUN/Cr ratios greater than 30 corresponded to patients with documented upper gastrointestinal bleeding sources. Calculation of the BUN/Cr ratio in the initial evaluation of gastrointestinal bleeding may prove useful in guiding the sequence of diagnostic procedures and examinations.
authors.affiliation: Division of Digestive Diseases and Nutrition, Children's Hospital of Los Angeles, CA 90027.
authors.forename: S
authors.initials: S
authors.lastname: Felber
authors.forename: P
authors.initials: P
authors.lastname: Rosenthal
authors.forename: D
authors.initials: D
authors.lastname: Henton
mesh_terms: D000293:Adolescent; D001806:Blood Urea Nitrogen; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000032:analysis*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies
chemical_list: D003404:Creatinine