ABSTRACT
Upper gastrointestinal bleeding (UGI) is from a source between the pharynx and the ligament of Trietz. It can present either as hematemesis or melena. Esophagogastroduodenoscopy is the initial diagnostic procedure of choice with the benefit of direct access to the bleeding site for diagnosis and management. Swallowed blood from a supraesophageal source can present similar to esophageal and gastric bleeding. A careful nasal and oral examination is important for children with UGI bleeding. Goals of therapy include: resuscitation, volume and blood replacement; assuring adequate platelets and coagulation factors; identification and control of bleeding source; and prevention of future bleeding episodes. Bleeding is an uncommon complication of eosinophilic esophagitis. More commonly children present with dysphagia or feeding aversion in infancy. Gastric antral vascular ectasia is a rare cause of gastric bleeding often associated with systemic illnesses: cirrhosis of the liver, autoimmune connective tissue diseases, and chronic renal failure.
