Infants who experience gastrointestinal bleeding (GIB) often require the services of a pediatric gastroenterologist for diagnostic and therapeutic endoscopy. Endoscopy’s benefits and potential side effects are little understood among this group. The purpose of this research was to report on the results of endoscopy in newborns diagnosed with GIB. Hospitalized children less than or equal to 12 months who were treated with an esophagogastroduodenoscopy (EGD) and/or colonoscopy/flexible sigmoidoscopy (COL) for GIB were the subjects of a retrospective, single-center cohort research. Infants could be tracked using international disease classification codes, quality control logs, and current procedural technology codes. From 2008 to 2019, 56 newborns were uncovered (51.8% female; mean age, 161.6 days). Stomach ulcers, a duodenal ulcer, gastric angiodysplasia, esophageal varices, and an anastomotic ulcer were seen in 7 endoscopies, all of which were causes of GIB. Treatments included esophageal varices banding/sclerotherapy and triamcinolone injection for an anastomotic ulcer in 3 infants. Endoscopy revealed gastric perforation, jejunal perforation at an anastomotic stricture, necrotizing enterocolitis totalis with perforation, Meckel’s diverticulum, and duodenal ulcer in 6 babies who underwent abdominal surgery for GIB or suspected intestinal perforation. There was 1 infant who was diagnosed with GIB and underwent surgery, but the cause of the bleeding could not be located. There was an increased risk of necessitating surgery in respiratory failure cases, using vasopressors or octreotide, delivering blood products, and high blood urea nitrogen (all P<0.05). In babies less than or equal to 12 months with clinical GIB, endoscopy had a modest value. Endoscopy in young infants is risky, and 3 of the infants in this series developed a gastrointestinal (GI) perforation soon after the surgery. These considerations should be considered when making clinical decisions about endoscopy for newborns with GIB.
Source: journals.lww.com/jpgn/Abstract/2022/10000/Endoscopy_in_Infants_With_Gastrointestinal.25.aspx
