Korean J Pediatr Gastroenterol Nutr.  2011 Jun;14(2):155-160. 10.5223/kjpgn.2011.14.2.155.

The Role of Colonoscopy in Children with Hematochezia

• We JH
• Park HS
• Park JH

• KMID: 2276536
• DOI: http://doi.org/10.5223/kjpgn.2011.14.2.155

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.

Keyword

Hematochezia; Child; Colonoscopy

MeSH Terms

Cecum
Child
Colitis
Colon, Ascending
Colon, Descending
Colon, Sigmoid
Colon, Transverse
Colonoscopy
Conscious Sedation
Dilatation, Pathologic
Female
Gastrointestinal Hemorrhage
Hemostasis, Endoscopic
Humans
Ileum
Male
Medical Records
Polyps
Proctocolitis
Rectum
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1 Localization of the hemorrhage.

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