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Gastrointestinal bleeding (GIB) in a child, whether through the mouth/nose or through the anus, is not a rare event. GIB varies from life-threatening variceal bleeding that requires urgent endoscopy to minor occult bleeding due to milk protein intolerance that is treated with dietary interventions. A systematic approach to the initial response and diagnosis will almost always result in finding the cause of the bleeding and an appropriate treatment. In this article we review the presentation, causes, investigations, and treatments of upper GIB (UGIB) and lower GIB (LGIB). (Table 1)

The first and most important assessment is whether a child is hemodynamically unstable or is at risk for becoming unstable. If stable, investigations and planned interventions can occur without excessive time pressure. If the child is not hemodynamically stable, then the child must be stabilized. Initial measures include ensuring an...

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