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Perforated peptic ulcers in children: a systematic review
Stipe Vidović1, Sara Borović2, Marko Bašković3,4
1Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, 31 000, Croatia.
BMC Pediatrics
|May 7, 2025
Summary
Perforated peptic ulcers (PPU) in children are more common in males and the duodenum. Surgical repair, often with sutures, is effective, showing low complication and mortality rates.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Research
Background:
- Perforated peptic ulcers (PPU) are a serious complication of peptic ulcer disease with high mortality.
- No prior systematic reviews exist for PPU in the pediatric population.
- This review synthesizes current knowledge on PPU in children.
Purpose of the Study:
- To systematically review the literature on perforated peptic ulcers in children.
- To identify risk factors, common etiologies, and treatment strategies for pediatric PPU.
- To summarize outcomes, including complication and mortality rates.
Main Methods:
- A systematic literature search was conducted across four major databases (Web of Science, Scopus, PubMed, ScienceDirect).
- PRISMA guidelines were followed for study selection and data extraction.
- Included studies focused on perforated peptic ulcers in patients under 18 years old, published in English.
Main Results:
- Twelve studies comprising 239 pediatric patients were analyzed.
- PPU was more frequent in males (74.8%) and in the duodenum (73%).
- Surgical intervention, primarily open repair with sutures, was performed in 86.6% of cases, with a 3.8% mortality rate.
Conclusions:
- Perforated peptic ulcers in children predominantly affect males and the duodenum.
- Suturing with or without an omental patch is a common and effective treatment.
- Further research is needed for more robust evidence on pediatric PPU management.
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