Details
Category: Volume 05 Issue 09 September 2017
Hits: 1352

Title: Clinical Profile of Bleeding per Rectum in Children between 1 and 12 years of Age- Prospective Study

Authors: Dr K. Thilakavathi MD[PED], Dr Sumathi Bavanandam M.D; D.C.H; D.M (Gastro), Dr Nirmala Dheivamani, M.D; D.C.H; D.M (Gastro), Dr B. Bhaskar Raju, M.D; D.C.H;  MNAMS; D.M (Gastro)

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i9.142

Abstract

Introduction: Bleeding per rectum in children is not uncommon and has diverse etiology.

Aim: clinical profile, outcome of colonoscopy in south Indian children with rectal bleeding is not available.

Materials and Methods: A prospective two years study (2006-08), is conducted to analyze the clinical and etiological profile of rectal bleed in children between 1-12 years of age at Institute of Child Health & Hospital for Children, Chennai, a large tertiary care pediatric center in southern India. Demographic details, clinical profile and colonoscopic findings were entered in a prestructured proforma and were analyzed.

Results: The mean age of occurrence of bleeding per rectum is 5.4 + 1.9 years without statistical significance between urban and rural children with equal male female distribution. Solitary juvenile polyp is an important cause of rectal bleed in children. Colonoscopy is a safe procedure and has both diagnostic and therapeutic role in children with bleeding per rectum.

Keywords: Bleeding per rectum, Colonoscopy, Children.

References

  1. Nelson Text Book of Pediatrics Kliegman, Behrman, Jenson, Stanton, Vol-2, Chapter XVIII.
  2. Grance HE Gastrointestinal bleeding n Yammada T, Alpeis D, Lasin el, Editors, Text book of Gastro Enterology 3rd edition. London: Williams and Wilkins 1999 P. 714-42.
  3. Turck D Michael L - LGI Bleeding in Wallen WA Goulet O, Kleinman RE. Editors Pediatric Gastroingtestinal 4th ed.
  4. Clarke G, RobbA Sugarman I Macallionwa. Investigating painless Rectal bleeding-is there scope for improperment J.Ped. Sug. 2005: 1970-2.
  5. Farzenebh Motamed et al., Colonoscopic examination in Children with Lower GI bleeding. Pediatric unit of Digestive Disease research centre, Gharib Ave.
  6. Arrola T. Ruusha T Keronan J, Hyoty H. Salminen.S. Isolam's E Rectal bleeding in infancy clinical, allergological and Micro-biological ..... pediatric 2006 117 760-8.
  7. Khurana A.K.Saraya.A., Jain N., Chandra M., Kulshreshta R. Department of Medicine, Safdarjung Hospital, New Delhi, India. Profile of lower gastrointestinal bleeding in children from a tropical country. Trop Gastroenterol 1998 Apr-Jun; 19(2): 70-1 Links.
  8. Garcia Sanchez M et al. Unidad Clinica de Aparatwe Digestivo, Cordoda, Spain. January 1998 and April 2000.
  9. Mandhan P et.al., Liaquat University of Medical Health Sciences Pakistan.
  10. Balcon E et al., Sigmoidoscopy in Minor Lower GI bleeding. Arch Disc child 1998 78:267.
  11. Bhargava DK, et. al., Rai RR, Dasarathy S, Chopra P. Department of Gastroent-erology, All India Institute of Medical Sciences, New Delhi. Colonoscopy for unexplained lower gastrointestinal bleeding in a tropical country.
  12. Goenka M.K. Kochhar. R. Mehta SK. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh. “Spectrum of lower gastrointestinal hemorrhage, an endoscopic study of 166” patients. Indian J.Gastroenterol. 1993 Oct: 12(4): 129-131 Links.
  13. FI-Mouzan MI et al., Abdullah AM. Department of Pediatrics, Division of Gastroenterology, College of Medicine, Kind Khalid University Hospital, Kind Saud University, P.O.Box, 2925, Riyadh 11461, Kingdom of Saudi Arabia. Yield of Colonoscopy in children with rectal bleeding.
  14. Sotomayor J, Bordas JM, Parri F, Julia V, Mondelo F, Morales L, Teres J. Section de Endoscopia Digestiva, Hospital Clinico Y. Provincial, Barcelona. Fiber Colonoscopy in children under 18.
  15. Cyanon HA Rilor DE Andus JM ...... of colonic polyps in children J.pediatric 1989 114 593-6.
  16. Thomson M. Ileocolonoscopy & Entero-scopy In: Walker WA Goulet & Klienman RE editors pediatrics Gastrointestinal Disease 4th ed. Hamilton BC .... 2004 P 1703-24.
  17. Lewis JD, Brown A, Localio AR et al. Initial evaluation of Rectal bleeding in young persons a cost effective analysis.
  18. Mehanna D, Platelic: Investigating chronic bright red rectal bleeding ANZ J Surg 2001 Dec 7(12) 720-2.
  19. Lott TT, Nicholl, R Domizio P ,Rectal bleeding and polyps, Arch Disc child 1993 69144-7
  20. Poddas U Iheopo BR Vaiphei K. colonic Polyps experience of 236 Indian children AM I Gastro enterol 1998 93(619-22).
  21. Mestre JM The charging pattern of Juvenile polyps AMJ Gasteroenterology 1989 81: 312-4.
  22. Holguson & Miller R Zinlelhi juvenile polyps of colon surgery 1971 69  288-93.
  23. Lower Gastrointestinal Bleeding : Surgical Perspective: Article by Burt Cagir Last up date July 7, 2005.
  24. Tone MC Gomez V. Tiscarreno HM Mayans JR Angiodysplasia of colon in children J. Paediatric Surg. 1995 30:72-5.
  25. Motamed et al.F Review of etiological of GI bleeding in children > 1 month old referred to Nimazi hospital of Shiraz from  mehr 80 - mehr.          81 2003.
  26. Teach S. Fleiscter, G. Rectal bleeding in pediatric Emergency Department. Ann Emergency Med 1994 23: 1252.
  27. O'hara S.M. Acute Gastrointestinal bleeding Radiol clin North Am. 1997 35: 879.
  28. Latt TT Nicholl R Donigiro et al, Rectal bleeding & polyps Arch Disc. child 1993:69:144.
  29. Vinton N. Gastrointestinal bleeding in infancy and childhood. Gastro Enterol, Clin North America 1994 23 93-122
  30. Hyan 35, heichtner A.M. Schwaitz an Recent advances in Diagnosis Treatment in Gastro Intestinal hemorrhage in infants & children J.Pediatric 1985/06 1-9
  31. Treem W.GI bleeding in children GI Endus Clin North Am 1994:4:75-97.
  32. Casarella WJ., Galloway SJ, Taxin RN: "Lower" gastrointestinal tract hemorrhage: new concepts basec arteriography. Am J.Roentgenol Radium Ther Nucl Med 1974 Jun: 121(2):357-68(Medline).
  33. Emslie JT,Zarnegar K, Siegel ME: Technetium-99m-labeled red blood cell scans in the investigation c bleeding. Dis Colon Rectum 1996 Jul: 39(7): 750-4 (Medline).
  34. Ernst O. Bulois P. ASaint-Drenant S, et al: Helical CT in acute lower gastrointestinal bleeding. Eur Radio (1): 114-7(Medline)
  35. Guy GE, Shetty PC, Sharma RP: Acute lower gastrointestinal emorrhage:treatment by superselectiv with polyvinyl alcohol particles. AJR M J Roentgenol 1992 Sep; 159(3) 521-6 (Medline)
  36. Kouraklis G, Misiakos E, Karatzas G: Diagnostic approach and anagement of active lower gastrointe hemorrhage. Int Surg 1995 Apr-Jun; 80(2): 138-40(Medline)
  37. Leitman IM, Paull DE, Shires GT: Evaluation and Management of massive lower gastrointestinal hemc 1989 Feb; 209(2) 175-80 (Medline)
  38. Longstreth GF: Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal population-based swtudy. Am J Gastroenterol 1997 Mar; 92(3): 419-24 (Medline)
  39. Parkes BM, Obeid FN, Sorensen VJ: The management of massive lower gastrointestinal bleeding. Arr 59(10): 676-8 (Medline)
  40. Vernava AM, Longo WE, Virgo KS: a nationwide study of the incidence and etiology of lower gastroint. Surg Res Commun 1996; 18: 113-120.
  41. Yamaguchi T, Yoshikawa K: Enhanced CT for initial localization of active lower gastrointestinal bleedir Imaging 2003 Sep-Oct; 28 (5) : 634-6 (Medline)

Corresponding Author

Dr K. Thilakavathi MD [PED]

Senior Assistant Professor of Pediatrics, Government Villupuram Medical College, Villupuram

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.