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Original Research

RMJ. 2019; 44(4): 717-720

Various causes of bleeding per rectum in children presenting at a tertiary care hospital

Asma Naz, Ejaz ur Rehman, Shabita Bai, Rukhsana Hamid, Muhammad Shahid Ghaffar, Geeta Kumari.

Objective: To determine the causes of lower gastrointestinal bleeding in our pediatric population.
Methodology: This non-interventional descriptive study was carried out at department of pediatric medicine at Creek General Hospital and Sindh Government Korangi Hospital, Karachi, Pakistan. It includes 100 patients with bleeding per rectum of more than 15 days duration. The detailed clinical history was recorded followed by digital rectal examination. Then these patients were subjected to relevant investigations including complete blood count, prothrombin time, activated partial thromboplastin time, bleeding time, stool detailed report, stool culture and sensitivity, barium enema, proctosigmoidoscopy, colonoscopy, upper gastrointestinal endoscopy and histopathy of the biopsy, as indicated by history and examination.
Results: The mean age of patients was 7.49± 2.81 years. Sixty three were male and 37 were female. Juvenile colorectal polyp was the commonest cause of rectal bleeding (44%). This was followed by non specific colitis in 20%, ulcerative colitis in 12%, and amoebic colitis in 8% patients. Lymphoid nodular hyperplasia and solitary rectal ulcer syndrome accounted for 3% each; whereas Meckel’s diverticulum, juvenile polyposis coli, chronic anal fissures and allergic colitis accounted for 2% each. Hemorrhoids and rectal prolapse were observed in 1% each.
Conclusion: Majority of cases of prolonged rectal bleeding in children were due to etiologies that carry little morbidity and rare mortality, but need to be investigated and treated in timely manner. Most of the cases with bleeding were due to colorectal causes that lie within the diagnostic reach of the sigmidoscopy /colonoscopy .

Key words: Bleeding per rectum, Juvenile colorectal polyp, ulcerative colitis.

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