title: Availability of blood urea nitrogen/creatinine ratio in gastrointestinal bleeding with melena in children.
abstract: OBJECTIVE
  The aims of our study were to evaluate the blood urea nitrogen to creatinine ratio (BUN/Cr ratio) for distinguishing between an upper and lower gastrointestinal bleeding (GIB), and differentiating between the two most common causes of upper gastrointestinal bleeding (UGIB) presenting with melena in children.
  
  
  METHODS
  Retrospective data of patients with GIB presenting with melena were analyzed. The data from 60 cases were reviewed including demographics, laboratory findings, diagnostic modalities and results, treatments, and transfusions.
  
  
  RESULTS
  Among the 60 cases, UGIB and lower gastrointestinal bleeding (LGIB) were found in 35 cases (58.3%) and 14 cases (23.3%), respectively. The two common causes of UGIB were varices (37.1%), and peptic ulcer diseases (PUD) (31.4%). The BUN/Cr ratio of 30 or greater was higher in UGIB than LGIB (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 1.3-37.2). In UGIB, the BUN/Cr ratio of the varices group was higher than that of the PUD group (p=0.015). The OR for the BUN/Cr ratio appeared as 1.2 per unit increase in the varices group than the PUD group (95% CI, 1.03-1.3). There was no difference between the PUD group and Meckel's diverticulum group.
  
  
  CONCLUSIONS
  The BUN/Cr ratio was not uneven in differentiating UGIB from LGIB of children with melena in our study. This suggests that BUN/Cr ratio should be interpreted carefully.
authors: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors: Kyu Seon
authors: KS
authors: Kim
authors: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors: Chan Ho
authors: CH
authors: Kang
authors: Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
authors: Jae Young
authors: JY
authors: Kim
keywords: Bleeding; Child; Gastrointestinal; Melena