681 Clinicopathological Aspects of Lower Gastrointestinal Bleeding in Children: A Single Center Experience From Southern Iran

Purpose To determine the common etiologies and characteristics of lower gastrointestinal bleeding in children in southern Iran. Methods This study was performed from March 2006 to March 2011 in Nemazee Hospital. All pediatric patients who referred to our center with visible lower gastrointestinal bleeding or two consecutive positive occult blood tests with at least one week interval were included in the study. The patients were categorized as neonates (1–28 days), infants (29 days-2 years), children (2–10 years) and adolescents (>10 years) and the findings were reported separately in each group. All the patients underwent colonoscopy and several mucosal biopsies where taken. Demographic and clinical information as well as colonoscopy and pathology findings were reported. Results We included 363 pediatric patients with a mean age of 71.9±58.4 months, ranging from 1 to 216 months. There were 215 (59.2%) boys and 148 (40.8%) girls. The most common colonoscopy finding was sigmoid colon polyp in 91 (25.1%) patients followed by descending colon petechia in 78 (21.5%) patients, rectal whitish lesions in 45 (12.4%) patients, and sigmoid and rectal ulcers in 37 (10.2%) patients. Biopsy samples were non-specific in 96 (26.4%) patients. The most common pathological finding was juvenile polyp in 84 (23.1%) patients followed by lymphoid nodular hyperplasia in 55 (15.2%) patients and solitary rectal ulcers in 25 (6.9%) patients. Conclusions Lower GI bleeding is more common among 2–10 year-old children and is rarely encountered in neonates. Hematochezia was the most common form of presentation followed by bloody diarrhea and occult blood.