Diseases Involving Rectal Bleeding in Children

Abstract

Gastrointestinal bleeding occurring in children is usually noticed as rectal bleeding. Since the introduction of prophylactic treatment for esophageal varices, we have rarely experienced hematemesis. On the other hand, the incidence of melena/hematochezia tends to increase year by year. It is particularly important to rapidly identify and to adequately manage life-threatening rectal bleeding because it requires emergency intervention. A total of 605 cases with diseases accompanied by rectal bleedind admitted by our department in the period of the last 30 years since 1974 were reviewed with respect to the characteristics of each main disease, the frequency of melena/hematochezia, sex, age-related incidence, diagnostic methods, and treatments. The 605 cases were found to range in age from zero days to 15 years of age, with a mean of 3.55 years. The male to female ratio was 1.7: 1.0. Of the diseases noted, those requiring emergency intervention included intussusception, malrotation, strangulation of the ileus, intestinal perforation, NEC, Meckel's diverticulum, UC, AGML, acute appendicitis with pelvic sepsis, and gastric hemorrhage post polypectomy. Death occurred in two cases of midgut volvulus and NEC.