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Lethal gastric rupture caused by acute gastric ulcer in a 6-year-old girl

Nobuyuki Morikawa1, Toshiro Honna, Tatsuo Kuroda

  • 1Department of Surgery, National center for child health and development, 2-10-1 Ookura Setagaya-ku, Tokyo, 157-8535, Japan. morikawa-n@ncchd.go.jp

Pediatric Surgery International
|September 10, 2005
PubMed

Insights

A rare case of gastric rupture in a 6-year-old girl highlights the importance of considering childhood ulcers as a cause. Early diagnosis and treatment are crucial for survival in pediatric gastric emergencies.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Emergency Medicine

Background:

  • Gastric rupture is exceptionally rare in children outside the neonatal period.
  • This case presents a previously healthy 6-year-old girl with a significant gastric injury.

Observation:

  • The patient presented with vertigo, intractable vomiting, and epigastric pain, progressing to cardiac arrest.
  • Physical examination revealed abdominal distension but no muscular rigidity.
  • Imaging confirmed free air and ascites, leading to exploratory laparotomy.

Findings:

  • A large laceration was found on the posterior wall along the greater curvature of the stomach.
  • Pathology indicated mucosal necrosis consistent with an acute gastric ulcer, despite intact musculature.

Implications:

  • This case underscores the critical need for prompt diagnosis and management of pediatric gastric rupture.
  • Clinicians should consider acute gastric ulcers as a potential cause of gastric perforation in children.
  • Timely intervention is vital for improving prognosis in these rare pediatric surgical emergencies.

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