Pediatric emergency medicine trisk 0696 0696
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TABLE 33.5
COMMON CAUSES OF LOWER GASTROINTESTINAL BLEEDING BASED
ON AGE
Neonatal period
Swallowed maternal blood
Infectious colitis
Allergic colitis
Infancy
Anal fissure
Infectious colitis
Allergic colitis
Preschool age
Anal fissure
Infectious colitis
School age and adolescents
Infectious colitis
Intestinal polyp
TABLE 33.6
LIFE-THREATENING CAUSES OF LOWER GASTROINTESTINAL
BLEEDING
Necrotizing enterocolitis
Hirschsprung-associated enterocolitis (toxic megacolon)
Midgut volvulus
Intussusception
Meckel diverticulum
Hemolytic uremic syndrome
Pseudomembranous colitis
Ischemic colitis
Peptic ulcer
Angiodysplasia
FPIES
In ill-appearing neonates with lower GI bleeding, midgut volvulus, NEC, and
Hirschsprung disease should be considered ( Table 33.4 ). Malrotation with midgut
volvulus is most common during this period presenting initially with bilious vomiting,
abdominal distention, and pain. Melena is seen in 10% to 20% of patients with midgut
