Publication: Stress Induced Gastric Ulcers: Presenting as Massive Rectal Bleeding in a Newborn
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Severe gastrointestinal bleeding in newborn period is a serious but uncommon
phenomenon that has a broad differential diagnosis. Primary duodenal ulcers
are rare in children but stress induced ulceration in stomach occurs more often
in neonatal period due to birth asphyxia, prolonged labour, cesarean deliveries,
instrumentations, respiratory distress syndrome and sepsis. These present as
acute onset of gastrointestinal bleeding commonly as altered gastric aspirate,
hematemesis or malena. We report a case of a neonate with stress induced gastric
bleeding following birth asphyxia who presented with massive gastrointestinal
bleed manifesting as hematemesis and massive rectal bleeding. Resuscitation with
multiple blood transfusion and parenteral use of ranitidine controlled the bleeding.
Stress induced gastric ulcers should be suspected in a neonate presenting with
massive gastrointestinal bleeding after difficult delivery and birth asphyxia.
KEY WORDS
Birth asphyxia, massive rectal bleeding, newborns, stress ulcers
Description
Joshi A, Shrestha PS, Dangol S, Shrestha NC, Poudyal P, Shrestha A
Department of Pediatrics
Dhulikhel Hospital, Kathmandu University Hospital
Dhulikhel, Kavre, Nepal
Keywords
Birth asphyxia, Massive rectal bleeding, Newborns, Stress ulcers