Advances in standardized diagnosis and management of pediatric gastrointestinal bleeding.

Abstract

Background: Gastrointestinal bleeding (GIB) is a prevalent clinical condition in pediatric populations that is characterized by etiological heterogeneity across age groups with potentially life-threatening risks in critical cases. Current management strategies predominantly extrapolate from adult-based studies and guidelines. This is despite substantial differences between pediatric and adult patients regarding bleeding etiology, risk stratification, peri-endoscopic pharmacotherapy, hemostatic technique selection, and salvage interventions after initial hemostasis failure.

Data sources: A systematic literature review was conducted via PubMed, Embase, and the Chinese Journal Full-text Database up to February 2025. Search terms included "pediatric", "upper gastrointestinal bleeding", "peptic ulcer", "lower gastrointestinal bleeding" and "endoscopic diagnosis and treatment". This review synthesizes current evidence to optimize standardized management of pediatric GIB.

Results: Early and comprehensive assessment of children with GIB, early identification of high-risk factors for GIB, timely use of endoscopic examination, proactive treatment, optimization of diagnosis and treatment processes, and multidisciplinary consultation have important impacts on the outcome of GIB in children.

Conclusions: Ensuring hemodynamic stability and vital signs in children with GIB, early identification of disease cause and timely, and effective hemostatic treatment are key to improving treatment success, reducing complications and lowering mortality.