Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2024; 16(1): 44-50
Published online Jan 16, 2024. doi: 10.4253/wjge.v16.i1.44
Upper gastrointestinal bleeding in Bangladeshi children: Analysis of 100 cases
Md Wahiduzzaman Mazumder, Md Benzamin
Md Wahiduzzaman Mazumder, Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh
Md Benzamin, Department of Pediatric Gastroenterology and Nutrition, Sylhet M A G Osmani Medical College Hospital, Sylhet 3100, Bangladesh
Author contributions: Mazumder MW designed the research study and performed the research; Benzamin M analyzed the data and wrote the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the departmental Ethics Committee of the Department of Pediatric Gastroenterology and Nutrition of Bangabandhu Shiekh Mujib Medical University (Approval No. BSMMU/Ped. Gastro/2023/122).
Informed consent statement: As this was a retrospective study, consent from parents/patients was unnecessary.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Md Wahiduzzaman Mazumder, FCPS, MD (Pediatric Gastroenterology), Associate professor, Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh. mazumdermw@gmail.com
Received: October 16, 2023
Peer-review started: October 16, 2023
First decision: November 9, 2023
Revised: November 20, 2023
Accepted: December 7, 2023
Article in press: December 7, 2023
Published online: January 16, 2024
Research background

Upper gastrointestinal bleeding (UGIB) is defined as bleeding that occurs proximal to the ligament of Treitz and can sometimes lead to potentially serious and life-threatening clinical situations in children. The etiology of UGIB in children is diverse and causes vary with age, geographical location and associated comorbidity.

Research motivation

There is a paucity of data regarding the etiology, mode of presentation and endoscopic findings of UGIB in children of Bangladesh.

Research objectives

The purpose of the study was to observe endoscopic findings of 100 cases of UGIB that were admitted in the Department of Pediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, a tertiary care hospital of Bangladesh.

Research methods

This retrospective observational study was carried out in the department of Pediatric Gastroenterology of Bangabandhu Sheikh Mujib Medical University of Bangladesh. Data were collected from hospital records after approval from the departmental ethical committee. In total, 100 children who were 16 years of age or younger presented with hematemesis and/or melaena and underwent upper gastrointestinal endoscopy after stabilization of vitals within 24-48 h. Patients who were older than 16 years of age or presented with bright red per rectal bleeding were excluded. All patients were treated according to the standard departmental protocol. The study was approved by the departmental Ethics Committee. Statistical analysis were performed using frequency, means, standard deviations and proportions.

Research results

A total of 100 patients were studied. UGIB was most common in the 5-10 years age group (42%), followed by those older than 10 years (37%). Hematemesis was the most common presenting symptom (75%) followed by both hematemesis and melena (25%). UGIB from ruptured esophageal varices was the most common cause (65%) on upper gastrointestinal endoscopy followed by gastric erosion (5%) and prolapsed gastropathy (2%). We observed that 23% of patients had a normal endoscopy.

Research conclusions

Upper gastrointestinal endoscopic evaluation of children with UGIB showed that ruptured esophageal varices were the most common cause of UGIB in Bangladesh. Non-gastrointestinal causes like hemophilia may also present with gastrointestinal bleeding.

Research perspectives

Further multicenter studies should be conducted to determine non-gastrointestinal causes of UGIB.