- Clinical context (Hematemesis, melena — resuscitate ABC, PPI, consider variceal vs non-variceal causes in children)
First-line therapy
Supportive + PPI (if indicated) • i.v./p.o.
Duration: Until hemostasis · Volume resuscitation, Hb monitoring, urgent endoscopy per stability — antibiotics if variceal bleed per local protocol
Ceftriaxone • i.v. • 50–50 mg/kg/day • 1×/day
Duration: 5–7 days · Variceal hemorrhage prophylaxis of SBP per adult-derived protocols in select pediatric cirrhosis — specialist guidance
Clinical notes
- • Pediatric causes: esophagitis, Mallory-Weiss, varices, ulcers, vascular malformations — tailor workup to age.
- • Antibiotics for bleeding: primarily in portal hypertension/variceal context or if perforation/infection — not routine all upper GI bleeds.
- • NASPGHAN — GI bleeding in children (2023)
