TY  - CHAP
M1  - Book, Section
TI  - Chapter 387. Upper and Lower Gastrointestinal Bleeding
A1  - Noel, Richard J.
A2  - Rudolph, Colin D.
A2  - Rudolph, Abraham M.
A2  - Lister, George E.
A2  - First, Lewis R.
A2  - Gershon, Anne A.
PY  - 2011
T2  - Rudolph's Pediatrics, 22e
AB  - Gastrointestinal  (GI)  bleeding  occurs  rarely  in  children;  severity  varies  from  the  insidious  bleed,  with  only  iron-deficiency  anemia  suggestive  of  occult  hemorrhage,  to  dramatic  hemorrhage  with  rapidly  evolving,  life-threatening  hypovolemic  shock.  Upper  GI  bleeding  is  bleeding  from  a  source  proximal  to  the  ligament  of  Treitz  (duodenojejunal  junction).  Hematemesis  is  the  vomiting  of  frank  blood  and  suggests  a  rapidly  bleeding  lesion.  Coffee-ground  emesis  describes  the  appearance  of  vomited  blood  that  has  been  coagulated  by  gastric  acid.  Hematochezia  is  blood  passed  with  stool  from  the  anus.  Blood  limited  to  the  outside  of  otherwise  unremarkable  stool  suggests  a  rectal  origin;  blood  mixed  throughout  the  stool  suggests  a  colonic  source.  Melena  is  black,  tarry  stool  produced  by  the  oxidation  of  heme  by  intestinal  flora;  as  little  as  50  mL  of  blood  may  result  in  melena,  and  it  may  persist  for  3  to  5  days  following  resolution  of  the  bleed.  Maroon-colored  stool  is  associated  with  rapidly  bleeding  small  bowel  lesions  in  which  the  transit  of  blood  is  too  fast  for  complete  oxidation.  Currant-jelly  stool  is  associated  with  ischemic  small  bowel  or  proximal  colonic  lesions  such  as  may  be  seen  in  intussusception.  Occult  GI  bleeding  is  bleeding  that  occurs  in  the  absence  of  overt  bleeding  and  is  usually  suspected  due  to  chronic  iron-deficiency  anemia  or  is  identified  by  hemoccult  examination.1  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=7035906
ER  -