ترجمه مقاله نقش ضروری ارتباطات 6G با چشم انداز صنعت 4.0
- مبلغ: ۸۶,۰۰۰ تومان
ترجمه مقاله پایداری توسعه شهری، تعدیل ساختار صنعتی و کارایی کاربری زمین
- مبلغ: ۹۱,۰۰۰ تومان
Upper gastrointestinal (UGI) bleeding (arising proximal to the ligament of Treitz in the distal duodenum) commonly presents with hematemesis (vomiting of red blood or coee ground-like material) and/or melena (black, tarry stools). In comparison, hematochezia (bright red or maroon-colored blood or fresh clots per rectum) is usually a sign of a lower gastrointestinal (LGI) source (dened as distal to the ligament of Treitz). The initial approach to a child with suspected UGI bleeding is discussed in this topic review. The approach to LGI bleeding in children, or to UGI bleeding in adults, is reviewed separately. (See "Lower gastrointestinal bleeding in children: Causes and diagnostic approach" and "Approach to acute upper gastrointestinal bleeding in adults".)
EPIDEMIOLOGY
The incidence of UGI bleeding is not well established in children. As much as 20 percent of all episodes of gastrointestinal (GI) bleeding in children come from a UGI source [1]. A populationbased study from France estimated that UGI bleeding occurred in 1 to 2 per 10,000 children per year (77 percent of whom required hospitalization) and that exposure to nonsteroidal antiinammatory drugs (NSAIDs) played a role in 36 percent of these cases [2].
SUMMARY AND RECOMMENDATIONS
Upper gastrointestinal (UGI) bleeding can present with hematemesis (vomiting of blood or coee ground-like material) and/or melena (black, tarry stools). The appearance of the stool is not a reliable indicator of the source of the bleeding. Although melena suggests UGI bleeding, it may also occur in patients with a proximal lower gastrointestinal (LGI) source. Conversely, patients with brisk UGI bleeding and rapid intestinal transit time may present with hematochezia, particularly if they are infants or toddlers. (See 'Clinical presentation' above.)