Management of Upper Gastrointestinal Bleeding in Children: Variceal and Nonvariceal

Abstract

Upper gastrointestinal (UGI) bleeding is generally defined as bleeding proximal to the ligament of Treitz, which leads to hematemesis. There are several causes of UGI bleeding necessitating a detailed history to rule out comorbid conditions, medications, and possible exposures. In addition, the severity, timing, duration, and volume of the bleeding are important details to note for management purposes. Despite the source of the bleeding, acid suppression with a proton-pump inhibitor has been shown to be effective in minimizing rebleeding. Endoscopy remains the interventional modality of choice for both nonvariceal and variceal bleeds because it can be diagnostic and therapeutic.

Keywords: Coffee-ground emesis; Hematemesis; Nonvariceal bleeding; Therapeutic endoscopy; Upper gastrointestinal bleeding; Variceal bleeding.