All issues > Volume 32(10); 1989

Original Article

J Korean Pediatr Soc. 1989;32(10):1360-1368. Published online October 31, 1989.

Peptic Ulcer in Infants and Children.

Bo Young Lee¹, Jae Kyoun Rhin¹, Ki Sup Chung¹

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea

Received: April 10, 1989;  Accepted: July 3, 1989.

Abstract

The authors clinically observed 60 patients with peptic ulcers who had been admitted to Severance Hospital, Yonsei University College of Medicine during the 9 year period from May 1979 to May 1988. The results were as follows: 1) Age and sex incidence of peptic ulcer patients from 5 months old to 17 years old showed that males predominated in a proportion of 1.5:1 and 88.3% were 6 years of age or older. Under the age of 6, the incidence of gastric ulcer and duodenal ulcer was approximately the same and above the age of 6, duodenal ulcer was 2.2 times more frequent than gastric ulcer. 2) Probable etiologic factors were identified in 8 (13.3%) of the 60 patients. Four cases were caused by drugs (aspirin, steroid, glacial acetic acid) and the other 4 were caused by psychological factors. 3) The symptoms were abdominal pain in 42 patients (71.6%), hematemesis or melena in 24 patients (40.0%) and vomiting in 12 patients (20.0%). With increasing age, abdominal pain also increased and with decreasing age, gastrointestinal bleeding increased. 4) Of the 24 patients who had gastrointestinal bleeding, 18 patients (75.0%) had duodenal ulcers. All of them had melena. Four (80.0%) out of 5 gastric ulcer patients demonstrated hematemesis while only 4 (22.2%) of the 18 duodenal ulcer patients demonstrated hematemesis. Seven (29.2%) of the 24 cases showed severe anemia (Hb<7 g/dl) and the majority of these were duodenal ulcer patients. 5) The rate of peptic ulcer diagnosed by upper gastrointestinal barium study and gastric endoscopy simultaneously was 48.3% Specifically, according to the region of the ulcer, rates for duodenal ulcer and for gastric ulcer by both studies were 50.0% and 44.4% respectively. 6) According to 仕te region of the ulcer, there were 36 patints (60.0%) with duodenal ulcers, 18 patients (30.0%) with gastric ulcers, 4 patients (6.7%) with gastroduodenal ulcers and 2 patients (3. 3%) with esophageal ulcers out of a total of 60 patients. There were 37 patients (61.7%) with a single ulcer and 23 patients (38.3%) with multiple ulcers. Of the 44 patients with dodenal ulcers, 43 patients (97.7%) had ulcers in the duodenal bulb, and of these patients, 26 (60.5%) had ulcers in the anterior wall. Out of the 36 patients with gastric ulcers, 11 patients (30.5%) had ulcers in the antrum and 25 patients (69.4%) in the anterior wall. 7) All 60 patients were treated medically : however, only 4 patients required operation due to complications. 8) Follow up endoscopy was possible in only 15 of the 60 patients, and of these patients, 10 patients (66.7%) remitted. Recurrence was found in 5 patients (33.3%) with duodenal ulcers. Since all of the recurrences occurred in patients with duodenal ulcers, the recurrence rate for the original 12 patients with duodenal ulcers was 41.7%.

Keywords :Peptic Ulcer, Gastric Ulcer, Duodenal Ulcer, Endoscopy