Evidence map›Paper›PMID 31300851›Full record

ArticlePediatric surgery international2019

Non-variceal gastrointestinal bleed in children: surgical experience with emphasis on management challenges.

Richa Lal, Surender K Yachha, Ankur Mandelia, Navdeep Dhoat, Divya Prakash, Moinak Sen Sarma, Rajanikant R Yadav, Anshu Srivastava, Ujjal Poddar, Anu Behari

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Article in Pediatric surgery international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Richa LalDepartment of Pediatric Surgical Superspecialties, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India. richalal@gmail.com.ORCID http://orcid.org/0000-0002-9512-6938
Surender K YachhaDepartment of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Ankur MandeliaDepartment of Pediatric Surgical Superspecialties, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India.
Navdeep DhoatDepartment of Pediatric Surgical Superspecialties, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India.
Divya PrakashDepartment of Pediatric Surgical Superspecialties, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, 226014, India.
Moinak Sen SarmaDepartment of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Rajanikant R YadavDepartment of Radio-diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Anshu SrivastavaDepartment of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Ujjal PoddarDepartment of Pediatric Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
Anu BehariDepartment of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis exclusively surgical series on pediatric non-variceal gastrointestinal bleed (NVGIB) defines three levels of bleed site and describes etiology, bleed severity, diagnostic algorithm, and surgical management for each bleed site. Management challenges are detailed.

methodsPatients aged ≤ 18 years treated surgically for NVGIB were analysed.

resultsBleed site (n = 87) was classified as: upper gastrointestinal bleed (UGIB; n = 11); small bowel bleed (SBB: n = 52); and lower GIB (n = 24). Four etiology-based groups were identified: lesions with ectopic gastric mucosa (EGM; n = 33), tumours (n = 23), ulcers (n = 21), and vascular pathology (n = 8). Bleed severity spectrum was: acute severe bleed (n = 12); subacute overt bleed (n = 59); and occult GIB (n = 16). Preoperative diagnosis was obtained in all UGIB and LGIB lesions. Eighty-two percent of surgical SB lesions were diagnosed preoperatively on Tc

conclusionsThe commonest site-specific bleed etiologies were duodenal ulcers for UGIB, EGM lesions for SBB, and tumours for LGIB. SBB presented diagnostic challenge. Diagnostic algorithm was tailored to bleed site, age-specific etiology, bleed severity, and associated abdominal/systemic symptoms. Management challenges were acute severe bleed, occult GIB, SBB, obscure GIB, and rare etiologies. IOE has a useful role in SBB management.

Indexed as

AdolescentAlgorithmsAneurysm, FalseCapsule EndoscopyChildChild, PreschoolChoristomaCrohn DiseaseDuodenal UlcerFemaleGastric MucosaGastrointestinal HemorrhageGastrointestinal NeoplasmsHepatic ArteryHumansInfantRadiopharmaceuticalsSodium Pertechnetate Tc 99mCapsule endoscopyComputed tomography enterography–angiographyIntra-operative enteroscopyNon-variceal gastrointestinal bleedTc99m pertechnetate scan

Identifiers

PMID31300851

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