How is the cause of lower gastrointestinal (GI) bleeding diagnosed in children younger than 2 years?

Updated: Dec 19, 2018
  • Author: Wayne Wolfram, MD, MPH; Chief Editor: Robert K Minkes, MD, PhD  more...
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Answer

Most polyps in persons of this age group are the juvenile type and are located throughout the colon. These are benign hamartomas and usually require no treatment, because they autoamputate. In cases of polyps, colonoscopy is the diagnostic evaluation of choice, because it allows examination of the entire colon and the potential excision of bleeding polyps when they are identified. Colonoscopy is helpful in diagnosing other polyposis syndromes, such as familial polyposis syndromes and adenomatous polyps.

In patients with Meckel diverticulum, technetium-99m (99m Tc) pertechnetate scanning is used to identify this congenital anomaly, with 90% accuracy. This isotope has a high affinity for parietal cells of gastric mucosa and allows identification of normal and ectopic gastric mucosa. The use of H2 blockers and proton pump inhibitors (PPIs), pentagastrin, and glucagon may enhance the accuracy of this test, since H2 blockers inhibit excretion of the isotope, pentagastrin enhances gastric mucosal uptake, and glucagon inhibits peristalsis.


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