Analysis Of The Etiology Of Hematochezia In 221 Hospitalized Infants

Objective:analyze and summarize the etiology of hematochezia and its correlations with related factors including gender and age among hospitalized infants from the Children's Hospital of Chenzhou Hospital Affiliated to University of South China,aiming at providing a reference for the clinical diagnosis and treatment of hematochezia in infants,and guiding clinicians to make timely etiological diagnosis and a reasonable plan for diagnosis and treatment,so as to reduce misdiagnosis and missed diagnosis.Methods:Infants with hematochezia and complete data hospitalized in the Children's Hospital of Chenzhou Hospital Affiliated to University of South China were collected from June 2013 to June 2016.Statistical analysis was conducted for the etiology of hematochezia in infants.Additionally,clinical characteristics and related factors of misdiagnosis were summarized.Results:(1)The top six causes of hematochezia in infants were allergic enteritis(n=50;23%),bacterial enteritis(n=48;22%),anal fissure(n=35;16%),stress ulcer(n=25;11%),intussusceptions(n=15;7%),and Meckel's diverticulum(n=12;5%),successively;(2)The etiology of hematochezia among infants with different ages showed significantly differences((?~2=123.563,P<0.001).In neonate group,the top three causes were stress ulcer,anal fissure and allergic enteritis;in young infant group,the top three causes were allergic enteritis,anal fissure and intestinal vascular malformation;in older infant group,the top three causes were bacterial enteritis,allergic enteritis and intussusceptions;(3)The etiology of hematochezia in infants was not correlated with gender((?~2=5.877,P=0.951);(4)The common allergens of allergic enteritis included milk,eggs,fish,shrimp,etc.,with milk as the main allergen.Among the 50 infants with allergic enteritis,46 were confirmed as allergy by milk protein,accounting for 92%;(5)Bacterial enteritis is a major infectious disease leading to hematochezia in infants.Among the 48 infants with bacterial enteritis,16showed positive stool culture,with 9 cases of Escherichia coli,5 cases of Salmonella typhimurium and 2 cases of Shigella flexneri;(6)Among the 221 infants with hematochezia,a total of 55 infants were misdiagnosed(misdiagnosis rate,24.9%).A total of 46 cases of medical diseases were misdiagnosed,with 44 cases misdiagnosed as allergic enteritis(misdiagnosis rate,88%;duration from onset to diagnosis,28.84±11.77 days),occupying the majority.Additionally,9 cases of surgical diseases were misdiagnosed,with4 cases misdiagnosed as intestinal vascular malformation(misdiagnosis rate,80%;duration from onset to diagnosis,45.68±22.75 days).Conclusion:The causes of hematochezia in infants are complex;moreover,misdiagnosis and missed diagnosis are commom,with allergic enteritis and intestinal vascular malformation showing the highest misdiagnosis rate.Therefore,it is of great significance to strengthen clinicians'understanding of hematochezia in infants.