Related Experiment Videos
[Peptic ulcer in children: diagnosis and treatment (author's transl)]
Insights
Peptic ulcers in children are more common than previously thought, affecting 23 patients over 14 years. Treatment is primarily conservative, with surgery reserved for severe complications like perforation or bleeding.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Surgery
Context:
- Peptic ulcer disease in children is a rare but significant condition.
- Diagnosis often occurs late, following complications such as perforation or bleeding.
Purpose:
- To analyze the incidence, clinical presentation, management, and outcomes of pediatric peptic ulcer disease.
- To evaluate the effectiveness of conservative and surgical interventions.
Summary:
- A 14-year study identified 23 pediatric patients with peptic ulcers (0.039% of inpatients). Acute ulcers presented in neonates or post-surgery, often diagnosed by complications. Chronic ulcers appeared after age six.
- Symptoms included abdominal pain, colic, perforation, and hemorrhage. Surgical interventions were performed for perforation (3 cases) and gastroduodenal hemorrhage (2 cases), with one neonatal mortality from sepsis and subarachnoid hemorrhage.
- Follow-up in 14 survivors showed no recurrence. The study concludes peptic ulcer is underdiagnosed in children, advocating for conservative management and minimal surgical intervention for complications.
Impact:
- Highlights the underestimation of pediatric peptic ulcer incidence.
- Provides evidence for conservative management strategies.
- Informs surgical decision-making for severe pediatric peptic ulcer complications.
Abstract:
Within a period of 14 years 23 children were treated for peptic ulcer (0.039% of all inpatients). Acute ulcers were seen in neonates or after major surgery, and were diagnosed only after perforation or bleeding. Chronic ulcers predominantly occurred after the sixth year. In addition to abdominal pain and colic, perforation and haemorrhage were also seen, the latter occasionally without previous symptoms. Three children were operated on for perforation, two for gastroduodenal haemorrhage. One of them, a neonate, died of septicaemia with subarachnoid haemorrhage. The bleedings were stopped by purse-string suture, the perforations by oversewing in two, local excision in one. Follow-up examination was undertaken in 14 of the 22 surviving children six months to 12 years after the initial manifestation. None had a recurrence. It is concluded that peptic ulcer is more frequent in children than is generally supposed. Treatment is mainly conservative. In case of perforation or haemorrhage the least possible surgical intervention should be practised.