ETIOLOGY OF LOWER GASTROINTESTINAL BLEEDING IN PAEDIATRIC PATIENTS, A COLONOSCOPIC SURGERY

Lower GI Bleeding in Children

Abstract

Objective: To determine the frequency of various etiologies of painless lower gastrointestinal bleeding (LGIB) in pediatric patients using colonoscopy.
Study Design: Cross sectional descriptive study.
Place and Duration of Study: This study was carried out at the department of Pediatrics, Military Hospital, Rawalpindi, from June 2010 to February 2012.
Patients and Methods: A total of 80 patients (2-18 years of age) presenting with painless lower gastrointestinal bleeding were subjected to fiber-optic colonoscopy and findings were recorded. Data was analyzed with the help of SPSS version 10. Descriptive statistics were used to determine the mean ± SD of numerical data, e.g., for age. Categorical data like gender and colonoscopic findings were analyzed by their frequencies and percentages.
Results: The study included 80 children out of which 53 were boys and 27 girls (male: female ratio was 1.96: 1). The majority of children, n=54 (67.5%) were between two and six years of age. The most common colonoscopic findings were polyps. In 47 (58.75%) patients, polyps were found in the colon and were resected. In 9 (11.25%) patients, gross appearance of colon was normal. Evidence of colitis was found in 17 (21.25%) patients. Patients with hemangiomas were 2 (2.5%). A total of 5 (6.25%) patients had non specific ulcerative lesions.
Conclusion: Polyps of the colorectal area are the most common cause of rectal bleeding in children in our set up. Thorough physical examination which includes a digital rectal examination and colonoscopy leads to rapid and accurate diagnosis and appropriate therapeutic measures.