Gastrointestinal bleeding

Abstract Acute gastrointestinal bleeding is uncommon in childhood. Whilst most episodes are mild and self-limiting, haemorrhage can occasionally be major and ongoing—and occasionally fatal. Successful management requires early identification of cases which are unlikely to stop bleeding spontaneously, and involvement of a team of experienced endoscopists, surgeons, and occasionally radiologists. In particular, the presence of shock should alert the clinical team to the risk of exsanguination and the likely need for surgical arrest of bleeding. The assessment and initial management of gastrointestinal bleeding in children are described. Available endoscopic, pharmacological, physical, and radiological methods of arresting haemorrhage are listed. Common and rare sources of blood loss are reviewed.