TONGUE ENDOMETRIOSIS SHOULD BE INCLUDED IN THE DIFFERENTIAL DIAGNOSIS OF HEMATEMESIS

Abstract Gastrointestinal bleeding (GIB) in pediatric patients can arise from a variety of underlying conditions. Current estimates indicate that the prevalence of GIB in children is approximately 6.4%, with about 80% of cases resolving spontaneously. However, the initial assessment and management are critical in influencing the overall prognosis. The primary focus should be on stabilizing the patient's hemodynamic status, followed by a comprehensive diagnostic evaluation. GIB may originate from either the upper or lower gastrointestinal tract, resulting in a wide differential diagnosis in infants and children. This differential includes both benign, self-limiting conditions and more serious disorders that require urgent intervention. Endometriosis should be included in the differential diagnosis of hematemesis. Endometriosis is a chronic gynecological condition characterized by the presence of endometrial glands and stroma located outside the uterine endometrium. This condition affects approximately 10 to 15% of women of reproductive age, with the ovaries being the most common site of involvement. At the extra pelvic level, the gastrointestinal and genitourinary tracts are the most frequently affected areas; however, endometriosis can develop in a variety of locations throughout the body. An 11-year-old female patient presented with hematemesis lasting four days, which coincided with the onset of her menstrual cycle and subsequently ceased. A diagnosis of endometriosis was established. Extra-pelvic endometriosis is rare, and accurate diagnosis necessitates both experience and specialized training in recognizing normal endometrial tissue. This case is significant as it represents the first reported instance of endometriosis located at the base of the tongue.