Peptic ulcer disease in children
Peptic Ulcer Disease in Children Peptic ulcer disease is rare in children. To obtain clinical data on this disease in children, Drumm and associates retrospectively reviewed the records of 36 children with peptic ulcer disease who presented to a children’s hospital during a five-year period. Only cases of definite ulcer crater, as identified by endoscopy or at surgery, were included in the study. There were 20 boys and 16 girls, whose ages ranged from three months to 17 years. Symptoms included abdominal pain, melena, hematemesis and vomiting. Duodenal ulcers were more common than gastric ulcers.
The patients were categorized into two groups: those with primary ulcers (19) and those with secondary ulcers (17). All of the peptic ulcers in patients under ten years of age were secondary in nature. Secondary ulcers usually were manifested by dramatic symptoms and occurred in association with a severe underlying disease (11 of the 17 patients); eight of these patients required emergency surgery. Three of the children with secondary ulcers died, but in two of these patients, the cause of death was attributed to the underlying disease. None of the surviving patients had chronic or recurrent symptoms. Children with primary peptic ulcer disease had more benign initial symptoms but a higher incidence of recurrent symptoms. Seven of these children required surgery.
Single-contrast barium radiographic examination was unreliable in establishing the diagnosis of peptic ulcer disease. Double-contrast studies may be more reliable, but until this technique is adequately evaluated, endoscopy is the procedure of choice for diagnosis. (Pediatrics, September 1988, vol. 82, p. 410.)
COPYRIGHT 1989 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group