Etiologies of upper gastrointestinal bleeding in children by age group, in approximate order of frequency

Neonate	Infant	Child or adolescent
Swallowed maternal blood*	Stress gastritis or ulcer^¶	Mallory-Weiss tear (associated with vomiting)
Vitamin K-deficient bleeding^Δ	Acid peptic disease^◊	Acid peptic disease^◊
Stress gastritis or ulcer^¶	Mallory-Weiss tear (associated with vomiting)	Gastric or esophageal varices
Esophagitis	Esophagitis	Esophagitis
Trauma (eg, nasogastric tube)	Vascular anomalies^§	Foreign body
Vascular anomalies^§	Gastrointestinal duplications	Caustic ingestion
Gastrointestinal duplications	Gastric or esophageal varices	Vasculitis (eg, Henoch-Schoenlein purpura)
Coagulopathy (eg, associated with infection)	Duodenal or gastric webs	Crohn disease
Milk protein intolerance	Bowel obstruction	Bowel obstruction
Congenital coagulation factor deficiency		Dieulafoy lesion
		Hemobilia

NSAIDs: nonsteroidal antiinflammatory drugs.
* This is a common cause of hematemesis in a newborn and is easily confused with upper gastrointestinal bleeding.
¶ Typically seen in critically ill infants; gastritis also may be caused by cytomegalovirus infection.
Δ Effectively prevented by vitamin K prophylaxis, which is usually given during routine neonatal care.
◊ Especially if NSAIDs have been given.
§ Vascular anomalies include hemangiomas, telangiectasias, and other vascular malformations.

Modified with permission from: Gilger MA. Upper Gastrointestinal Bleeding. In: Walker, Goulet, Kleinman, et al, Eds. Pediatric Gastrointestinal Disease, 4 Ed. B.C. Decker, Ontario, 2004. Copyright © 2004 PMPH-USA, Ltd. Additional data from: Chawla S, et al, Clinical Pediatrics 2007; 46:16.

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Etiologies of upper gastrointestinal bleeding in children by age group, in approximate order of frequency