Topics Discussed: gastroenterology and hepatology; gastrointestinal bleeding.
Sections: Definitions, Pathogenesis, Key Initial Steps in the Evaluation of GI Bleeding, Clinical Presentation, Differential Diagnosis Based on Presentation, Approach to Diagnosis and Management, Diagnostic Tests of Interest, Treatment, Summary, References.
Excerpt:"Gastrointestinal (GI) bleeding can be occult (not readily visible)
or overt. This chapter will focus on overt GI bleeding that is acute
or subacute. Separate chapters (e.g., Chapters 13 and 16) will cover
aspects of chronic or occult GI blood loss in more detail. The source
of visible blood in stool or vomit may be from the upper GI (UGI)
tract, lower GI (LGI) tract, extraintestinal (e.g., swallowed blood
from a nosebleed), or an exogenous substance (e.g., red-colored
foods). Regardless of the source, obvious blood from the GI tract
tends to be a very distressing problem for patients and their families
that quickly bring them to medical attention. GI bleeding can be
serious and life threatening. Thankfully, serious GI bleeding is
uncommon in the pediatric age group and the problem often resolves
without specific intervention. The key to approaching a patient
with GI bleeding is a rapid assessment of the severity of bleeding
and hemodynamic status of the child. Given the nature of the content,
this chapter will focus on differential diagnosis, diagnostic approach,
and treatment based on clinical presentation: hematemesis or coffee
ground emesis, hematochezia, and melena...."
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