Duodenal ulcer disease in chidren

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Peptic ulcer disease is prevalent in certain regions, including Assam, India.
• Chronic duodenal ulcers in children present diagnostic challenges, often requiring invasive procedures.
• Previous medical management has shown limited success in providing permanent relief for pediatric duodenal ulcers.

Purpose of the Study:

• To evaluate the efficacy of surgical treatment versus medical management for chronic duodenal ulcers in children.
• To analyze outcomes and identify predisposing factors in pediatric duodenal ulcer cases.
• To assess the surgical approach for duodenal ulcer perforation in infants.

Main Methods:

• Retrospective analysis of 11 pediatric cases of chronic duodenal ulcer over 7 years.
• Diagnosis confirmed via clinical symptoms, hyperchlorhydria, and barium meal X-rays.
• Surgical interventions included truncal vagotomy with drainage for ulcers and simple closure for perforations.

Main Results:

• Truncal vagotomy in 8 patients resulted in no deaths and long-term symptom relief for 6.
• Medical management failed to provide permanent relief.
• Simple closure of perforations in 3 infants led to fatalities due to septicemia.

Conclusions:

• Operative treatment, specifically truncal vagotomy, is recommended for chronic duodenal ulcers in children.
• Surgical management of duodenal ulcer perforation in infants carries a high risk of mortality.
• Predisposing factors include family history, blood group O, and regional diet.