Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(2) > 1043502

Korean J Pediatr Gastroenterol Nutr. 2011 Jun;14(2):155-160. Korean.
Published online June 30, 2011.  https://doi.org/10.5223/kjpgn.2011.14.2.155
Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
The Role of Colonoscopy in Children with Hematochezia
Ju Hee We, M.D., Hyun Suk Park, M.D. and Jae Hong Park, M.D.
Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea.

Corresponding author (Email: jhongpark@pusan.ac.kr )
Received February 09, 2011; Revised March 12, 2011; Accepted March 15, 2011.

Abstract

Purpose

This study was performed to evaluate the role of colonoscopy in children with hematochezia.

Methods

We retrospectively reviewed the medical records of 277 children who underwent colonoscopy because of hematochezia between January, 2003 and July, 2010.

Results

The mean age of the patients was 6.0±4.4 (7 days~17.8 years) years. The male to female ratio was 2.2 : 1. The duration between the 1st episode of hematochezia and colonoscopy was 4.9±12.1 months. Characteristics of hematochezia included red stool (65.1%), blood on wipe (12.8%), bloody toilet (11.9%), and blood dripping (10.2%). The most proximal region of colonoscopic approach was terminal ileum (84.5%), cecum (9.5%), hepatic flexure (2.8%), and splenic flexure (3.2%). Eighty five patients (30.6%) had no specific abnormal findings. Major causes of hematochezia were polyp (26.4%), food protein induced proctocolitis (6.9%), infectious colitis (5.4%), lymphofolliculitis (5.7%), non specific colitis (5.7%), and vascular ectasia (5.1%). The hemorrhagic sites included the rectum (24.0%), rectosigmoid junction (18.1%), sigmoid colon (13.5%), ascending colon (14.2%), transverse colon (11.3%), descending colon (7.8%), cecum (8.1%), and terminal ileum (3.1%). The recurrence rate of hematochezia after colonoscopy was 19.1%. Colonoscopy was performed in 262 patients (94.6%) with conscious sedation. Endoscopic hemostasis was performed in 5 patients. Complications of colonoscopy or sedation were not found.

Conclusion

The causes and lesional localization of pediatric hematochezia were diverse. Colonoscopy has an important role in the diagnosis and treatment of hematochezia in children. Total colonoscopy is recommended to detect the cause of hematochezia.

Keywords: Hematochezia; Child; Colonoscopy

Figures


Fig. 1
Localization of the hemorrhage.
Click for larger image

Tables


Table 1
Causes of Hematochezia
Click for larger image

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