Massive Gastrointestinal Bleeding in Neonates and Infants

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 25; no. 1; pp. 35 - 40
• Main Authors: Urushihara, Naoto, Ogura, Kaoru, Fukumoto, Kouji, Morimura, Toshiya, Hasegawa, Shirou, Furuta, Toshiyuki, Miyazaki, Eiji
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2005; 日本腹部救急医学会
• Subjects: 小児; 新生児; 消化管出血; 腸管血管腫
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.25.35

Causes of gastrointestinal bleeding are age-specific in children. Massive gastrointestinal bleeding is uncommon and can easily cause hypovolemic shock in neonates and infants. Initial management of massive bleeding consists of fluid and blood replacement, intubation with a nasogastric tube, and medical treatment. Vitamin K should be given intravenously, and oxygen should be administered as needed. If intravenous access is difficult to establish in volumecontracted infants, a central line, cutdown or intraosseous line should be established. Some patients need an emergency operation for the surgical disease. NEC, malrotation with midgut volvulus, and gastric rupture may cause massive bleeding in neonates. Intussusception, Meckel's diverticulum, and variceal rupture are frequent causes in infants and preschool children. Intestinal hemangiomas are rarely present in children, and angiography may be useful. The diagnosis and treatment of neonates and infants with massive gastrointestinal bleeding are discussed.