Upper gastrointestinal bleeding in children in Southern Iran.
OBJECTIVE
To find out whether the causes of upper GI bleeding in our center in a developing country differed from developed countries.


METHODS
Children presenting to our center with upper GI bleeding from March 2002 to March 2007, were retrospectively evaluated. Informations were retrieved from patient's history and physical examination and results of upper GI endoscopy regarding etiology of bleeding, managements, use of medications which might predispose patient to bleeding, and the mortality rate.


RESULTS
From 118 children (67 boys; with age of 7.7+/-4.7 yrs) who underwent upper GI endoscopies, 50% presented with hematemesis, 14% had melena and 36% had both. The most common causes of upper GI bleeding among all patients were gastric erosions (28%), esophageal varices (16%), duodenal erosions (10%), gastric ulcer (8.5%), Mallory Weiss syndrome tear (7.8%), duodenal ulcer (6.8%), esophagitis (1.7%) and duodenal ulcer with gastric ulcer (0.8%). The causes of bleeding could not be ascertained in 20.5% of cases. No significant pre-medication or procedure related complications were observed. Endoscopic therapy was performed in 13.5% of patients. In 14.4% of patients, there was a history of consumption of medications predisposing them to upper GI bleeding. Two deaths occurred (1.7%) too.


CONCLUSIONS
The findings in the present study showed that half of upper GI bleedings in pediatric patients from south of Iran, were due to gastric and duodenal erosions and ulcers. This study concludes that the causes of upper GI bleeding in children in our center of a developing country, are not different from those in developed ones.
Dehghani
Seyed Mohsen
SM
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. dehghanism@sums.ac.ir
Haghighat
Mahmood
M
Imanieh
Mohammad Hadi
MH
Tabebordbar
Mahmood Reza
MR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019049:Developed Countries / Q000706:statistics & numerical data; D003906:Developing Countries / Q000706:statistics & numerical data*; D004378:Duodenal Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D004381:Duodenal Ulcer / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D006396:Hematemesis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008551:Melena / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D013276:Stomach Ulcer / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology