Bleediing from the gastrintestinal tract is a reatively common occurence in infancy and child-hood.
Fortunately, in most cases a very careful history and physical examination will reveal the lesion responsible but occasionally the most exhaustive investigation will fail tc identify the hemorrhagic source.
In order to determine the patterns of gastrointestinal bleeding in infancy and childhood, a total 314 cases of gastrointestinal bleeding patients were ciinica´1-v reviewed who were admitted to the Department of uediatrics in Severance Hospital from May, 1967 to April, 1972.
The following results were obtained. ;
1) The incidence of gastrointestinal bleeding in infants and children was 5. 6% of a total 6,107 admissions. Sex incidence showed that males predominated in a proportion of 1.6 :
2) Analysis of gastrointestinal bleeding revealed that the most prevalent group was lover gastrointestinal bleeding (71.5%). Next were blood dyscrasias or systemic hemorrhagic diseases (13.40%), upper gastrointestinal bleeding (3.5%) and others group (11.6%) of which 4.9% were from unknown causes.
3) For age incidence the Highest was from 1 year to 6 years.
4) In upper gastrointestinal bleeding, duodenal ulcer gave the highest incidence (75%) and the next gastritis (16.7%).
In lower gastrointestinal bleeding, enterocolitis showed the highest incidence (76%) of which bacillary dysenter; was the commonest cause, and next intussusception (21.2%), Mackel´s diverticulum (0.8%), gangrene of ileum (0.8%), etc.
In blood dyscasias or systemic hemorrhagic diseases, the order of frequency was leukemia(26. 1 %), ITP (15.2%), aplastic anemia (13. 0%), hypoprothrombinemia (13.055), septicemia (13.0%), etc.
In others group the order of frequency of causes was unknown (42.5%), hepatitis (15.0%), encephalopathy (15. 0515), liver cirrhosis (15.0%), milk allergy (5.O%), etc.
5) Bleeding types of total gastrointestinal patients revealed that hematochezia was the highest (63.4%) and next melena (25.9%), hematemesis (6.1%) and hematemesis with melena (3.8%). In each subgroup of upper gastrointestinal bleeding hematemesis was the commonest (66.7%). In lower gastrointestinal bleeding hematechezia was the ccmmonest (83.8511o), and in blood dyscrarias or systemic hemorrhagic diseases and others group melena was the commonest (7I.7% and 47.5,,o respectively).
6) In degree of anemia by hemoglobin level most of gastrointestinal bleeding patients (71.8%) revealed a hemoglobin level of more than 10.Ogm%.
In each subgroup upper gastrointestinal bleeding revealed that hemoglobin level was under 7.0 gm% in 33.3% but lower gastrointestinal bleeding was 2.4%. In blood dyscrasias or systemic hemorrhagic diseases hemoglobin level was under 7.0 gm% in 45.796, and in others group hemoglobin level was more than 10.0 gm% in 60.0%.
7) Most of gastrointestinal bleeding patients received medical treatment (87.8%) but 12.2% received surgical treatment.
Total mortality rate of gastrointestinal Deeding was 12.2%. In each subgroup the mortality rate of upper gastrointentinal bleeding was 16.7% but in lower gastrointestinal bleeding it was 5.7%. Also in blood dyscrasias or systemic hemorrhagic diseases the mortality rate was relarively high (27.4% and 32.5% respectively).
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