Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital

  • Muhammad Abu Talib Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan
  • Muhammad Tariq Aziz The Children’s Hospital & The Institute of Child health, Multan
  • Hassan Suleman Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan
  • Ghazi Khan Khosa Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan
  • Saima Jabeen Joya Department of Paediatric Gastroenterology, Hepatology & Nutrition, The Children’s Hospital & The Institute of Child health, Multan, Pakistan
  • Ibrar Hussain Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan
Keywords: anemia, colonoscopy, lower gastrointestinal bleeding, Polyps, Colitis

Abstract

Objective: To determine etiology and outcome of children with lower gastrointestinal bleeding (LGIB).

Methods: This was a prospective study conducted at the Department of Pediatric Gastroenterology and Hepatology, Children’s Hospital and The Institute of Child’s Heath, Multan, Pakistan, from July 2019 to March 2020. A total of 148 cases presented with bleeding per rectum and underwent colonoscopy, were included. Children of both genders and aged three month to 15 years were included. Detailed history, clinical examination, laboratory studies, colonoscopy and histopathology were done in all cases. Study information like demographics, complaints, general clinical examination, colonoscopy and histopathological findings were recorded.

Results: Overall, mean age was noted to be 7.20±1.83 years. Abdominal pain was reported in 41 (27.7%), diarrhea 36 (24.3%), fever 12 (8.1%) and constipation in 4 (2.7%). Pallor was noted among 68 (45.9%), weight loss 39 (26.3%) and tachycardia 31 (20.9%). Colonoscopy revealed juvenile colonic / rectal polyps, infectious colitis and solitary rectal ulcer (SRU) as the most common etiologies found among 58 (39.2%), 20 (13.5%) and 19 (12.8%) cases respectively. Juvenile polyps and non-specific colitis were the commonest histopathological findings seen in 55 (37.2%) and 20 (13.5%) cases respectively. Colonoscopic polypectomy was used to remove all juvenile polyps.

Conclusion: LGIB is presentation of various underlying causes. Children with LGIB commonly present with abdominal pain. Juvenile polyps were the most frequent cause of LGIB among children flowed by non-specific colitis. Most of the children having LGIB were diagnosed and treated successfully, few are in remission and very few were found resistant to treatment.

doi: https://doi.org/10.12669/pjms.37.2.2676

How to cite this:
Talib MA, Aziz MT, Suleman H, Khosa GK, Joya SJ, Hussain I. Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital. Pak J Med Sci. 2021;37(2):---------.
doi: https://doi.org/10.12669/pjms.37.2.2676

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Muhammad Tariq Aziz, The Children’s Hospital & The Institute of Child health, Multan

MBBS, FCPS (Paeds Medicine)

Assistant Professor Paediatric Medicine, 

The Children’s Hospital & The Institute of Child health, Multan

 

Hassan Suleman, Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan

MBBS, FCPS (Paeds Medicine) FCPS (Paeds Gastroenterology)

Associate Professor, Department of Paediatric Gastroenterology & Hepatology

The Children’s Hospital & The Institute of Child health, Multan

 

Ghazi Khan Khosa, Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan

MBBS, FCPS (Paediatric Medicine),

Fellow Trainee Paediatric Gastroenterology

Assistant Professor (Paediatric Gastroenterology),

Department of Paediatric Gastroenterology & Hepatology,

The Children’s Hospital & The Institute of Child health, Multan

Saima Jabeen Joya, Department of Paediatric Gastroenterology, Hepatology & Nutrition, The Children’s Hospital & The Institute of Child health, Multan, Pakistan

MBBS, FCPS (Paediatric Medicine),

Fellow Trainee Paediatric Gastroenterology

Senior Registrar

Department of Paediatric Gastroenterology, Hepatology & Nutrition,

The Children’s Hospital & The Institute of Child health, Multan, Pakistan.

Ibrar Hussain, Department of Paediatric Gastroenterology & Hepatology, The Children’s Hospital & The Institute of Child health, Multan

MBBS, FCPS (Paediatric Medicine),

Fellow Trainee Paediatric Gastroenterology

Senior Registrar,

Department of Paediatric Gastroenterology & Hepatology,

The Children’s Hospital & The Institute of Child health, Multan

Published
2021-01-02
How to Cite
Talib, M., Aziz, M., Suleman, H., Khosa, G., Joya, S., & Hussain, I. (2021). Etiologies and outcome of lower gastrointestinal bleeding in patients presenting to a tertiary care Children’s Hospital. Pakistan Journal of Medical Sciences, 37(2). https://doi.org/10.12669/pjms.37.2.2676
Section
Original Articles