[Emergency endoscopy of the upper gastrointestinal tract and therapeutic endoscopic procedures in childhood (author's transl)]

Abstract

In the Department of Surgery, Bonn University Medical School, from 1.2.1977 - 1.8.1979 68 emergency endoscopies in children were performed. Up to the age of ten this was done with and over ten years without anaesthesia. The most frequent sources of bleeding in the specific groups were varices of the oesophagus and stomach. Further frequent sources of bleeding were duodenal ulcers, a Mallory-Weiss-syndrome, reflux-oesophagitis with hiatal hernia, erosions and polyps of the stomach and corrosive oesophagitis. The source of haemorrhage was found in 70%; a probable cause of bleeding was detected in 15%, in 6% no pathologic lesion was seen. In 42 children an operative endoscopy was used simultaneously: 41 times by a sclerosing procedure of the oesophageal wall, once in a bleeding polyp. Complications of the sclerotherapy were one case each of an incomplete wall necrosis of the oesophagus, a stenosis and a new bleeding from oesophageal varices. No child died. -The emergency endoscopy is able to improve the diagnosis of upper gastrointestinal bleeding. The decision for conservative or operative treatment can be made earlier and the results are more certain. The sclerotherapy of the oesophageal varices succeeded in stopping haemorrhage and preventing it in the future.