• Georges L. Kaiser


If blood is brought up (hematemesis) or evacuated by the anus (melena) that is recognizable clearly us such, the parents and the child are very frightened and the physician is consulted immediately. Other forms of gastrointestinal blood evacuation must be ascertained by asking or even tested for it. A precise history and inspection of vomited material or the evacuated intestinal content are particularly important. They permit to differentiate the common disorders that must be considered. Fresh or older blood may be vomited, regurgitated, or emptied from the oral cavity combined with blood clots in a large or small amount. In the latter condition, the amount of blood seems larger than really because of the mixture of saliva. Vomiting of hematin is often not payed attention to, mainly if only splashes of hematin mixed up with mucus or milk are distributed over the sheets. The same applies to gastric aspirate with fresh blood or coffee-ground.


Duodenal Ulcer Blood Clot Oral Cavity Peptic Ulcer Disease Esophageal Varix 
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General and Differential Diagnosis

  1. Arensman RM (1998) Gastrointestinal bleeding. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St LouisGoogle Scholar
  2. Boyle JT (1983) Gastrointestinal bleeding. In: Fleisher G, Ludwig S et al (eds) Text-book of pediatric emergency medicine. Williams & Wilkins, Baltimore/LondonGoogle Scholar

Section 22.1

  1. der Meulen J, for the National Prospective Tonsillectomy Audit (Royal College of Surgeons of England, London; et al) (2004) Tonsillectomy technique as a risk factor for postoperative Van Haemorrhage. Lancet 364:697–702PubMedCrossRefGoogle Scholar
  2. McGarry G (2006) Nosebleeds in children. Clin Evid 15:496–499Google Scholar

Section 22.2

  1. Ramenofsky ML (1986) Gastroesophageal reflux: clinical manifestations and diagnosis. In: Ashcraft KW, Holder TM (eds) Pediatric esophageal surgery. Grune & Stratton, OrlandoGoogle Scholar

Section 22.3

  1. Murphy MS, Eastham EJ (1987) Peptic ulcer disease in childhood: long-term prognosis. J Pediatr Gastroenterol Nutr 6:271–724CrossRefGoogle Scholar
  2. Murphy MS, Eastham EJ, Jimenez M, Nelson R, Jackson RH (1987) Duodenal ulceration: review of 110 cases. Arch Dis Child 62:554–558PubMedCrossRefGoogle Scholar
  3. Scherer LR (1998) Peptic ulcer and other conditions of the stomach. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St Louis, p MosbyGoogle Scholar

Differential Diagnosis

  1. Kibiki GS, Thielman NM, Maro VP, Sam NE, Dolmans WM, Crump JA (2006) Hookworm infection of the duodenum associated with dyspepsia and diagnosed by oesophagoduodenoscopy: case report. East Afr Med J 83:689–692PubMedGoogle Scholar
  2. Sauseng W, Benesch M, Lackner H, Urban C, Kronberger M, Gadner H, Höllwarth M, Spuller E, Aschauer M, Horcher E (2007) Clinical, radiological, and pathological findings in four children with gastrointestinal stromal tumor of the stomach. Pediatr Hematol Oncol 24:209–219PubMedCrossRefGoogle Scholar

Section 22.4

  1. Altman RP (1998) Portal hypertension. In: O’Neill JA Jr et al (eds) Pediatric surgery, vol II, 5th edn. Mosby, St LouisGoogle Scholar
  2. Brisse H, Orbach D, Lassau N, Servois V, Doz F, Debray D, Helfre S, Hatmann O, Neuenschwander S (2004) Portal vein thrombosis during antineoplastic chemotherapy in children: report of five cases and review of the literature. Eur J Cancer 40:2659–2666, Comment in: Eur J Cancer (2004) 40:2643–2644PubMedCrossRefGoogle Scholar
  3. Chardot C, Darani A, Dubois R, Mure PY, Pracros JP, Lachaux A (2009) Modified technique of meso-Rex shunt in case of insufficient length of the jugular vein graft. J Pediatr Surg 44:E9–12PubMedCrossRefGoogle Scholar
  4. Chawla Y, Duseja A, Dhiman RK (2009) Review article: the modern management of portal vein thrombosis. Aliment Pharmacol Ther 1(30):881–894CrossRefGoogle Scholar
  5. Clarc W, Hernandez J, McKeon B, Villadolid D, Al-Saadi S, Mullinax J, Ross SB, Rosemurgy AS II (2010) Surgical shunting versus transjugular intrahepatic portasystemic shunting for bleeding varices resulting from portal hypertension and cirrhosis: a meta-analysis. Am Surg 76:857–864Google Scholar
  6. Clatworthy HW Jr (1990) Big shunts for small patients with portal hypertension: a bit of history. J Pediatr Surg 25:1082–1084PubMedCrossRefGoogle Scholar
  7. Fonkalsrud EW (1982) Long-term results following surgical management of portal hypertension in childfren. Z Kinderchir 35:57–61PubMedGoogle Scholar
  8. Khuroo MS, Khuroo NS, Farahat KL, Khuroo YS, Sofi AA, Dahab ST (2005) Meta-analysis: endoscopic variceal ligation for primary prophylaxis of oesophageal variceal bleeding. Aliment Pharmacol Ther 15(21):347–361CrossRefGoogle Scholar
  9. Lillegard JB, Hanna AM, McKenzie TJ, Moir CR, Ishitani MB, Nagorney DM (2010) A single-institution review of portosystemic shunts in children. HPB Surg 2010, 2010: 964597Google Scholar
  10. Lorenz JM (2008) Placement of transjugular intrahepatic portosystemic shunts in children. Tech Vasc Interv Radiol 11:235–240PubMedCrossRefGoogle Scholar
  11. Meisheri IV, Kothari PR, Kumar A, Deshmukh A (2010) Splenic artery embolisation for portal hypertension in children. Afr J Paediatr Surg 7:86–91PubMedCrossRefGoogle Scholar
  12. Mileti E, Rosenthal P (2010) Management of portal hypertension in children. Curr Gastroenterol Rep 13:10–16CrossRefGoogle Scholar
  13. Mrad SM, Boukhthir S, Oubich F, Gharsallah L, Basaoui S (2007) Treatment of upper gastrointestinal bleeding in portal hypertension in children. Tunis Med 85:184–188PubMedGoogle Scholar
  14. Plessier A, Valla DC (2008) Budd-Chiari syndrome. Semin Liver Dis 28:259–269PubMedCrossRefGoogle Scholar
  15. Prasad R, Singh UK, Mishra OP, Jaiswal BP, Muthusami S (2010) Portal hypertension with visceral leishmaniasis. Indian Pediatr 7(47):965–967CrossRefGoogle Scholar
  16. Schettino GCM, Fagundes EDT, Roquete MLV, Ferreira AR, Penna FJ (2006) Portal vein thrombosis in children and adolescents. J Paediatr (Rio J) 82:171–178Google Scholar
  17. Sharif K, McKierman P, de Ville de Goyet J (2010) Mesoportal bypass for extrahepatic portal vein obstruction in children: close to a cure for most! J Pediatr Surg 45:272–276PubMedCrossRefGoogle Scholar
  18. Wolff M, Hirner A (2003) Current state of portosystemic shunt surgery. Langenbecks Arch Surg 388:141–149PubMedCrossRefGoogle Scholar
  19. Yachha SK, Chetri K, Lal R (2002) Management of portal hypertension. Indian J Pediatr 69:809–813PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Georges L. Kaiser
    • 1
  1. 1.Department of Pediatric Surgery InselspitalUniversity of BerneBerneSwitzerland

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