The evaluation of child patients performed endoscopy by the reason of gastrointestinal bleeding

Gastrointestinal system(GIS) endoscopy is a sensitive and reliable method for diagnostic and therapeutic purposes in GIS bleedings in children. In this study we planned to search clinical and laboratory features, and therapeutic and prognostic implications in the cases with GIS bleeding who has endoscopy. In this study, we included child patients evaluated by the reason of GIS bleeding, had endoscopy, and with full medical records in Pediatric Gastroenterology Clinic between January 2009 and January 2016. We included 374 patients (188 male and 186 female) with mean age 9.09±5.07 years, between 1 month and 18 years in the study. There were 226 patients with upper GIS bleeding (110 male, 116 female)with mean age 7.94±5.12 years in the study group. The endoscopic localisation of the lesion in these patients were stomach in 169 patients (74,8%), esophagus in 101 patients (41,7%) , and duodenum in 52 patients (23%). 149 out of 226 patients had endoscopy were made biopsy for histopathologic investigation. The crucial histopathologic findings were duodenitis in 95 patients (63,8%), gastritis in 94 (63,1%), H.Pylori positivity in 58 (38,9%), esophagitis in 28 (18,8%) and in 17 (11,4%) normal histopathology. Main endoscopic diagnoses in our cases with upper GIS bleeding were gastritis (43,8%), esophagitis (27,9%), cardioesophageal sphincter looseness (19%), gastric ulser (18,6%), duodenitis (9,7%), esophageal varices (7,5%), duodenal ulcer (7,1%), and normal GIS endoscopy. There were 148 patients with lower GIS bleeding (78 male, 70 female) with mean age 10.93±4.52 years in the study group. Main colonoscopic findings in our group were ulcer in colon in 51 patiens (34%), rectal ulcer in 22 (14,9%), polip in 14 (9,5%), lymphoid hyperplasia in ileum in 7 (4,7%), hemorhoid in 4 (2,7%), and normal colonoscopy in 42 (28,4%). 134 out of 148 patients had biopsy for histopatological investigation. Histopatological findings were colitis in 44 patients (32,8), ileitis in 9 (6,7%), polip in 8 (6%), and normal histopathology in 76 (56,7%). The diagnoses of the cases with lower GIS bleeding were inflammatory bowel disease in 50 (33,8%), rectal ulcer in 24 (16,2%), polip in 15 (10,1%) and hemorhoid in 3 (2%). We did not find any reason for bleeding in 42 patients (28,4%). When we compared cases with upper and lower GIS bleeding, the ages of cases with lower GIS bleeding were significantly higher than others. In this situation, there may play a role differences the diseases causing GIS bleeding and their appearance ages. The hematocrit and hemoglobin values of cases were sinificantly lower in the cases of upper GIS bleeding than the lower ones. This may be related with the seriousness of the diseases causing GIS bleeding. As a result, we believe that GIS endoscopy, an irrevocable method in the diagnosis and treatment of GIS diseases, will gain more importance by means of advances in the medicine and technology in coming years. Key words: Gastrointestinal bleeding, endoscopy, hematemesis, bloody stool.