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Portal hypertension and duodenal ulcer in children

Pei-Yin Hung1, Yen-Hsuan Ni, Hong-Yuan Hsu

  • 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Journal of Pediatric Gastroenterology and Nutrition
|July 23, 2004
PubMed

Insights

Duodenal ulcers (DU) are more common in children with portal hypertension, particularly those with a history of variceal bleeding. Screening for DU is crucial in pediatric patients with gastrointestinal bleeding and portal hypertension.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Gastrointestinal Endoscopy

Background:

  • Portal hypertension is associated with a higher prevalence of duodenal ulcers (DU) in adults.
  • The occurrence and characteristics of DU in pediatric populations with portal hypertension require further investigation.

Purpose of the Study:

  • To determine the prevalence and identify characteristics of duodenal ulcers in children with portal hypertension.
  • To explore potential contributing factors to DU development in this cohort.

Main Methods:

  • A cohort of 80 children with portal hypertension underwent upper intestinal endoscopy.
  • A control group of 80 age- and sex-matched children without liver disease was included.
  • Factors analyzed included liver disease severity, portal hypertension, H. pylori, and serum gastrin levels.

Main Results:

  • The prevalence of DU was significantly higher in children with portal hypertension (22.5%) compared to controls (8.8%).
  • DU was more frequent and occurred earlier in children with a history of variceal bleeding.
  • DU presence was not dependent on liver disease severity, H. pylori infection, or serum gastrin levels.

Conclusions:

  • Duodenal ulcers are common in children with portal hypertension, especially those with prior variceal bleeding.
  • Gastrointestinal bleeding in patients with portal hypertension warrants screening for DU, even with esophageal varices.
  • Elevated portal pressure may contribute to the development of duodenal ulcers in children.
Abstract

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