Age-specific causes of upper gastrointestinal bleeding in children

Figure 1 Anatomic locations of upper gastrointestinal bleeding in children, with corresponding common causes. CMPA: Cow’s milk protein allergy; NSAIDs: Non-steroidal anti-inflammatory drugs; PGS: Prolapse gastropathy syndrome.

Figure 2 The most common causes of upper gastrointestinal bleeding in children from 1-year-old to 3-years-old. A: Gastric ulcer in a 3-year-old boy who presented with hematemesis; B: Mallory-Weiss tear in a 3-year-old boy; C: Esophageal varices grade II in a 2-year-old boy with extrahepatic portal vein obstruction after cardiac surgery.

Figure 3 Causes of upper gastrointestinal bleeding in children older than 3-years-old. A: Erosive gastritis in a 14-year-old girl with cerebral palsy; B: Gastroesophageal varices type 2 in a 6-year-old girl with chronic liver disease due to extrahepatic portal vein obstruction; C: Macronodular gastritis in a 16-year-old girl due to Helicobacter pylori infection; D: Eosinophilic esophagitis in a 16-year-old boy; E: Gastric trichobezoar in a 9-year-old boy; F: Traumatic perforation of the duodenum as a consequence of a handlebar injury in a 6-year-old boy. The patient was referred to the hospital two days after injury and the surgery was performed on the day of admission.

Figure 4 Clinical approach to children with upper gastrointestinal bleeding. BS: Blakemore-Sengstaken; EST: Endoscopic sclerotherapy; EVL: Esophageal varices ligation; GI: Gastrointestinal; PPI: Proton pump inhibitor; TIPS: Transjugular intrahepatic portosystemic shunt; UGIB: Upper gastrointestinal bleeding; VS: Vital signs; NSAIDs: Non-steroidal anti-inflammatory drugs.