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[Gastroduodenal stress ulcer. A pediatric case report]
G Salvi1, R Mattei, F Pampaloni
1Dipartimento di Pediatria dell'Università di Firenze, Ospedale Meyer, Italia.
Summary
Post-rubella encephalitis in a child led to severe duodenal bleeding from stress ulcers. Surgery was necessary to manage recurrent hemorrhages, even with H2 receptor antagonist treatment.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Infectious Diseases
Background:
- Rubella encephalitis is a rare but serious complication of rubella infection.
- Stress ulcers can occur in critically ill children, leading to gastrointestinal bleeding.
- H2 receptor antagonists are a common treatment for acid suppression and ulcer prevention.
Observation:
- A six-year-old child developed encephalitis following a rubella infection.
- The child experienced severe, recurrent hemorrhagic episodes originating from a duodenal stress ulcer.
- Standard H2 receptor antagonist therapy proved insufficient to control the bleeding.
Findings:
- The case highlights a rare complication of post-rubella encephalitis involving significant gastrointestinal hemorrhage.
- Duodenal stress ulcers can present as a life-threatening complication in pediatric encephalitis.
- Surgical intervention was ultimately required to achieve hemostasis for intractable bleeding.
Implications:
- This case underscores the importance of vigilant monitoring for gastrointestinal complications in children with encephalitis.
- It suggests that severe stress ulcers in this context may necessitate aggressive management, including surgical options.
- Further research into the pathophysiology and optimal management of stress ulcers in pediatric encephalitis is warranted.