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Peptic ulcer disease in children and adolescents. A ten-year experience
Insights
Peptic ulcer disease (PUD) in children presents differently based on age. Stress ulcers occurred in younger children due to shock, while primary ulcers were more common in older children, often presenting with pain and bleeding.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Surgery
Background:
- Peptic ulcer disease (PUD) is a significant concern in pediatric populations.
- Understanding the distinct characteristics of primary versus stress ulcers in children is crucial for effective management.
Purpose of the Study:
- To review and analyze the clinical features, diagnosis, and management of peptic ulcer disease in children over a decade.
- To differentiate between primary peptic ulcers and stress ulcers in pediatric patients.
Main Methods:
- Retrospective chart review of 61 pediatric patients diagnosed with PUD between 1971 and 1980.
- Diagnostic methods included barium meal, endoscopy, surgical findings, and autopsy reports.
Main Results:
- Stress ulcers (30 cases) were more prevalent in children under 4, often linked to shock and frequently requiring surgery for complications like perforation or bleeding.
- Primary ulcers (31 cases) were more common in children over 4, with abdominal pain and gastrointestinal bleeding as primary symptoms. Medical management was typical, but one-third needed surgery for complications.
Conclusions:
- Pediatric PUD exhibits distinct patterns based on ulcer type and patient age.
- Prompt diagnosis and appropriate management, whether medical or surgical, are essential for favorable outcomes in pediatric PUD.
Abstract:
We report a retrospective review of peptic ulcer disease (PUD) in children seen at Children's Hospital of Michigan, over 10 years (1971-1980). Of the 61 included, 31 had primary ulcers and 30 had stress ulcers. The diagnosis was made by either barium meal or endoscopy, at surgery, or at autopsy. Stress ulcers were commoner in children less than 4 years of age and were precipitated by various conditions leading to shock. The majority of these patients required surgery for perforation or bleeding. Primary ulcers were more common in children older than 4 years. The most common presenting symptoms in this group were abdominal pain and gastrointestinal bleeding. The majority of patients with primary PUD received medical therapy in the form of antacids and/or cimetidine. In one-third of these patients, surgery was necessary for complications such as intractable pain, perforation, or massive recurrent hemorrhage.