All issues > Volume 38(3); 1995

Original Article

J Korean Pediatr Soc. 1995;38(3):339-346. Published online March 15, 1995.

Peptic Ulcer Disease in Infants and Children

In Sheol IS Park², Nam Su NS Kim², Poong Man PM Jung¹

¹Department of Pediatric Surgery, Hanyang University College of Medicine, Seoul,Kore
²Department of Pediatrics, Hanyang University College of Medicine, Seoul,Kore

Abstract

Purpose
: This study was performed to be helpful in early diagnosis and treatment of the children with peptic ulcer disease.
Methods
: The authors observed 36 children with peptic ulcer disease who had been admitted to Hanyang University Hospital during the 11 year 4 mont period from January 1981 to April 1992 retrospectively. The diagnosis was established in 33.3% by gastric endoscopy, in 25% by upper gastrointestinal barium study, in 11.7% by gastric endoscopy and upper gastrointestinal barium study simultaneously, and in 30% by emergency operation.
Results
: 1) Age and sex incidence of chidlren with peptic ulcer disease(3 days to 16 years old) showed that males predominated in a proportion of 8:1 and 83.3% were 7 years of age or older. Under the age of 7, the incidence of gastric ulcer was greater than that of duodenal ulcer and above the age of 7 duodenal ulcer was 2.6 times more frequent than gastric ulcer. 2) The chief comlaints on admission were abdominal pain in 17 patients(47%), hematemesis or melena in 15 patients(25%), vomiting in 6 patients(16%). There was a tendency that abdominal pain also increased as the age increased. 3) Most common blood type among 13 patients with duodenal ulcer was Rh+O type(53.8%). 4) Of the 15 children who had gastrointestinal bleeding, 10(43.3% of duodenal ulcer) were doudenal ulcer and 4(33.3% of gastric ulcer) were gastric ulcer. Severe anemia(Hb<7g/dl) was shown in only 5 patients with duodenal ulcer. 5) According to the region of the ulcer, 20(86.9%) of 23 children with doudenal ulcer had ulcers in doudenal bulb and 8(66.7%) of 12 children with gastric ulcer had ulcers in antrum. 6) 18 children with duodenal ulcer, 7 children with gastric ulcer and 1 child with gastroduodenal ulcer had complications. Of the 26 children, bleeding occured in 10 children, perforation occured in 7 children and obstruction occured in one child. 7) 23 children were treated medically and 13 children were treated surgically. 11 patients received operation due to panperitonitis(perforation), 1 patients(71%) were treated medically, however, under 7 year of age, 5 patients(62%) received surgical treatment. Surgical methods used were primary closure(4 patients), vagotomy with pyloroplasty(1 patients), subtotal gastrectomy with gastrojejunostomy(7 patients) and antrectomy with gastroduodenostomy(1 patients).
Conclusion
: We conclude that it is important to diagnose early peptic ulcer disease in children, who have nonspecific symptoms and signs above mentioned, to prevent possible complications including failure to thrive.

Keywords :Peptic ulcer disease, Children