Paediatric-History taking & Physical examination of gastrointestinal bleeding in children

Paediatric-History taking & Physical examination of gastrointestinal bleeding in childrenCreated OnApril 23, 2020Last Updated OnApril 23, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking & Physical examination of gastrointestinal bleeding in children < All Topics Table of Contents History taking: Ask about chief complaint and history of presenting illness Duration of bleeding, Color and quantity of the blood in stool or emesis, Antecedent symptoms, History of straining, Abdominal pain, or Trauma A history of vomiting, diarrhea, fever, ill contacts, or travel could indicate infectious origin. Bloody diarrhea and signs of obstruction suggest volvulus, intussusception, or necrotizing enterocolitis, particularly in the ex-premature infant. Recurrent or forceful vomiting is associated with Mallory-Weiss tears. Familial history or nonsteroidal anti-inflammatory drug (NSAID) use may suggest ulcer disease. History of drug ingestion such as anti-coagulants should be asked. (such as NSAIDs, tetracyclines, steroids, caustics, and foreign bodies, can irritate the gastric mucosa enough to cause blood to be mixed with the vomitus, Recent jaundice, easy bleeding tendencies, and changes in stool color may suggest liver disease. For complaints of bloody stool, it is important to elicit on history foods or drugs that may give a stool bloody appearance. Such as certain antibiotics, iron supplements, red licorice, chocolate, Kool-Aid, flavored gelatin, or bismuth-containing products (eg, Pepto-Bismol). Physical examination: Document the vital signs and sign of shock heart rate, blood pressure, capillary refill, and orthostatic changes. During examination of the head, ears, eyes, nose, and throat, look for causes such as epistaxis, nasal polyps, and oropharyngeal erosions from caustics and other ingestions. Look for abdominal surgical scars and ask the reason for the surgery. bowel sound frequency is important to elicit. (for example, hyperactive bowel sounds are more common in upper GI bleeding.) Abdominal tenderness, with or without a mass, could be due to intussusception...

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