Gastrointestinal bleeding in infants and children

GI bleeding can occur in any area of the GI tract, from the mouth to the anus. For severe bleeding, the sequence of management is first to stabilize the patient (including establishing intravenous access), followed by identifying the source of bleeding. The differential diagnosis is prioritized by addressing the clinical presentation of the bleeding and the age of the patient. Best outcomes are achieved by a timely multidisciplinary approach, using the combined skills of a pediatric gastroenterologist, radiologist, and surgeon. With the availability of a broad array of endoscopic and radiologic techniques for accurate diagnosis and the advent of innovative methods for controlling GI bleeding, the major challenge in the coming years will be to determine the optimal approach to the individual patient based on assessment of risk status. As described in the case study, management based on empiric diagnosis remains an acceptable approach for many of the conditions that cause GI bleeding in children.