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Clinical features of severe acute upper gastrointestinal bleeding in children

Clinical features of severe acute upper gastrointestinal bleeding in children
Clinical features of severe acute upper gastrointestinal bleeding in children
  • Hemodynamic instability (tachycardia or prolonged capillary refill time, with or without hypotension) or generally unwell appearance
  • Melena or large hematochezia
  • Large-volume hematemesis or nasogastric aspirates (this can be very difficult to estimate due to dilution)
  • Known or suspected esophageal varices (eg, known liver disease or splenomegaly) or intestinal surgery
  • Significant anemia (ie, hemoglobin >20% below lower limit for age, decrease of >20% from a recent value, or need for transfusion)
References:
  1. Freedman SB, Stewart C, Rumantir M, Thull-Freedman JD. Predictors of clinically significant upper gastrointestinal hemorrhage among children with hematemesis. J Pediatr Gastroenterol Nutr 2012; 54:737.
  2. Thomson MA, Leton N, Belsha D. Acute upper gastrointestinal bleeding in childhood: Development of the Sheffield scoring system to predict need for endoscopic therapy. J Pediatr Gastroenterol Nutr 2015; 60:632.
  3. Quitadamo P, Anselmi F, Mantegazza C, et al. Hematemesis in infants: The first evidence-based score to predict the need for timely endoscopy. Pediatr Emerg Care 2022; 38:e1245.
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