Wajeehuddin, Ali Raza Brohi.
Per rectal bleeding in children; a clinical experience.
J Surg Pak Jan ;13(2):47-50.

Objectives: To find out different causes and management of bleeding per rectum in infants and children. Design: Descriptive study. Place and Duration of study: The study was conducted at various hospitals where authors worked, from January 2005 to December 2007. Patients and Methods: All children under 12 years of age presenting with a common symptom of bleeding per rectum were included. The data was reviewed for age, gender, clinical characteristics and management. In all cases CBC and in selective cases stool DR were done. Some patients were subjected to sigmoidoscopy. Rectal polyp and mucosal biopsy were sent for histopathology. Result: The study included 80 patients, of whom 57 (71.25 %) were boys and 23(28.75%) girls with male to female ratio of 2.5:1. The mean age at diagnosis was 6.31 years. Rectal polyps were the most common cause and found in 45(56.25%) children. Polyps were diagnosed with digital rectal examination and by sigmoidoscopy. Twenty one (26.25%) children were treated conservatively with the suspicion of infectious colitis. Non specific colitis (n=2), intusssusception (n=3), Meckel`s diverticulum(n=1), ulcerative colitis(n=2) and anal fissure(n=2) were the other causes. Conclusions: Colorectal polyps are common cause of rectal bleeding in children. Proper physical examination including per rectal digital examination along with the endoscopy promotes both rapid and accurate diagnosis and the opportunity for immediate therapeutic measures.

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