Pediatric emergency medicine trisk 0688 0688
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in the ED. Often, when the infant has been at the breast for a few moments and then is
pulled away, obvious bleeding from the mother’s nipple is apparent, providing
reassurance to both physicians and parents.
TABLE 33.1
Etiology of Upper Gastrointestinal Bleeding Based on Age a
Neonatal period (
<4 wks)
Infancy ( <2 yrs)
Preschool age (2–5 School age ( >5
yrs)
yrs) and
adolescents
Swallowed maternal Gastritis
blood
Gastritis
Esophagitis
Peptic ulcer
Mallory–Weiss tear
Epistaxis
Gastritis
Gastritis
Esophagitis
Mallory–Weiss tear
Peptic ulcer
Idiopathic
Vitamin K–deficient
bleeding
Esophagitis
Intestinal
duplication
Vascular
malformation
Pyloric stenosis
Trauma (NG tube)
Milk protein allergy
Mallory–Weiss tear
Toxic ingestion
Peptic ulcer
Stress ulcer
Toxic ingestion
Esophagitis
Foreign body
Vascular
malformation
Esophageal varices
Hemobilia
Vasculitis
Crohn disease
Esophageal varices
Vascular
malformation
Hemobilia
a In
Peptic ulcer
Foreign body
Pyloric stenosis (<2
mo of age)
Vascular
malformation
Toxic ingestion
Intestinal
duplication
Gastric or duodenal
web
approximate order of frequency of occurrence.
