Upper Gastrointestinal Bleeding, Pediatric

Michael A. Manfredi, MD Reviewed 10/2018

BASICS

DESCRIPTION

Upper gastrointestinal bleeding (UGIB) is classified based on its origin of bleeding being proximal to the ligament of Treitz. The classic clinical symptom is hematemesis which is em...

DIAGNOSIS

The initial evaluation of patients presenting with GI bleeding focuses on assessment of vital signs, history of present illness, focused medical history, physical examination, and lab testin...

TREATMENT

GENERAL MEASURES

Initial management:
- Patients should be made NPO.
- Have stable IV access.
- Obtain blood type, and cross-match RBCs.
- Stabilize the patient with IV fluids and blood products if necess...

ONGOING CARE

Monitor hemoglobin in the hospital until patient’s condition is stable.
If bleeding has stopped, endoscopy should still be strongly considered to diagnose source of bleeding.
Once patient i...

ADDITIONAL READING

Chawla S, Seth D, Mahajan P, et al. Upper gastrointestinal bleeding in children. Clin Pediatr (Phila). 2007;46(1):16–21. [View Abstract on OvidInsights]
Kato S, Sherman PM. Wha...

CODES

ICD9

578.9 Hemorrhage of gastrointestinal tract, unspecified
578.0 Hematemesis
578.1 Blood in stool

ICD10

K92.2 Gastrointestinal hemorrhage, unspecified
K92.0 Hematemesis
K92.1 Melena

SNOMED

37372002 Upp...

FAQ

Q: When do you refer a patient with suspected active upper GI bleeding?
A: Immediately, especially if the patient is hemodynamically unstable; urgently, in patients with evidence of chronic iron-de...

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