Open Access, Peer-reviewed
pISSN 2234-8646
eISSN 2234-8840
    Korean J Pediatr Gastroenterol Nutr. 2011 Jun;14(2):155-160. Korean.
    Published online Jun 30, 2011.
    https://doi.org/10.5223/kjpgn.2011.14.2.155
    Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
    Original Article

    The Role of Colonoscopy in Children with Hematochezia

    Ju Hee We, M.D., Hyun Suk Park, M.D. and Jae Hong Park, M.D.
      • Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea.
    • Corresponding author (Email: jhongpark@pusan.ac.kr )
    Received February 09, 2011; Revised March 12, 2011; Accepted March 15, 2011.

    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.

    Keywords
    Hematochezia; Child; Colonoscopy

    Figures

    Fig. 1
    Localization of the hemorrhage.

    Tables

    Table 1
    Causes of Hematochezia

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    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
    Metrics
    Share
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