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March 1964

Gastrointestinal Bleeding of "Unknown Origin": A Study of Cases in Infancy and Childhood

Author Affiliations

Donald Brayton, MD, 1216 Wilshire Blvd, Los Angeles, Calif 90017; From the Department of Surgery, Los Angeles Childrens Hospital, Associate Clinical Professor of Surgery, University of California School of Medicine.

Am J Dis Child. 1964;107(3):288-292. doi:10.1001/archpedi.1964.02080060290012

Some years ago we studied and reported a series of 428 cases of gastrointestinal bleeding in infancy and childhood from the Childrens Hospital of Los Angeles.3 Of special interest in that series was the diagnosis and management of the "primary bleeder"—that is, the patient in whom the gastrointestinal hemorrhage was continuously- the primary and leading complaint, in contradistinction to those patients in whom the bleeding occurred as an incidental feature of some other well-delineated disease or syndrome. These cases of primary gastrointestinal hemorrhage numbered 171 (40% of the series) and were found to be due to a variety of causes, the most important of which were oesophageal varices (17), peptic ulcer (11), polyps of colon (40), Meckel's diverticulum (27), enterocolitis and ulcerative colitis (24), and unknown (25).

Since the clinical diagnosis of bleeding Meckel's diverticulum cannot usually be made by roentgenographic or laboratory methods currently available, it has become