THE INTEREST OF EMERGENCY FIBROSCOPY IN C HILDRENS DIGESTIVE UPPER TRACT HEMORRHAGE - A PROSPECTIVE-STUDY OF 100 CASES

The interest of emergency fibroscopy in children's digestive upper tra ct haemorrhage, A prospective study of 100 cases, -This prospective st udy investigated 100 cases of digestive upper tract bleeding (DUTH) ob served in the Pediatric Unit B of Tunis Children's Hospital, from Janu ary to December 1994. DUTH represented 12.5% of the endoscopic indicat ions in our Unit. Upper tract digestive fibrescopy was performed withi n 12 hours of the onset of DUTH in 11 cases, between 12 and 24 hours i n 40 cases and after 24 hours in 49 cases. It allowed a lesional diagn osis in 90 % cases, and lather than 24 hours in 49 cases. A lesional d iagnosis was made in 90% of cases, when endoscopy was performed within the first 24 hours, vs. 57% when performed later (p<0.01). Histologic al and bacteriological testing of perendoscopic antral biopsies has im proved the diagnostic performance of digestive fibrescopy (74% vs. 78% ). A review of the various aethiogies showed there are two predominant causes for children's DUTH, i.e. peptic oesophagitis (22% of cases) a nd Helicobacter pylori gastritis (16%), as well as a newly identified children's disease, neonatal oesogastritis (14% of cases).