Clinical and Endoscopic pattern in children presented with upper and lower gastrointestinal bleeding in Sohag University Hospital

Background: Gastrointestinal bleeding (GIB) is a  common health problem in children , which can induce anxiety in both the pediatric patients and their parents.
Objective: To delineate the clinical profile and endoscopic pattern of children admitted to Sohag University Hospital due to overt GIB.
Patients and Methods: This study was a one-year prospective observational study (August 2022 - July 2023) undertaken in the Pediatric Department of Sohag University Hospital. The study population consisted of 118 children who were referred with overt GIB. For each participant, the following information was documented: full medical history, thorough physical examination, laboratory investigations, as well as endoscopic and histopathologic findings.
Results: Sixty six males and 52 females were included. Their ages ranged from 6 months to 14 years, with a median age of 8 years. A total of 55.1% of cases presented with upper GIB and 44.9% presented with bleeding per rectum .Endoscopic diagnosis could be reached in 66.9% of cases and 33.1% had normal endoscopy. The most common endoscopic diagnosis was esophageal varices in 23/118 cases and colorectal polyps in 17 patients  followed by gastritis in 16/118 patients, ulcerative colitis in 7/118 cases and solitary rectal ulcer  in 6/118 cases with colorectal polyps significantly more frequent in 2-7 years age group and solitary rectal ulcer and ulcerative colitis were more common in 7-14 years age group (P-value > 0.05).
Conclusion: Our study confirms that gastrointestinal endoscopy is the preferred method for both diagnosing and treating GIB in children. UGIB was more prevalent than LGIB. The most frequent causes of GIB in our cohort were esophageal varices, followed by colorectal polyps and gastritis. Notably, colorectal polyps were more common in younger children, while solitary rectal ulcers and ulcerative colitis were more frequently observed in older children.