Journal of the Korean Pediatric Society 1995;38(3):339-346.
Published online March 15, 1995.
Peptic Ulcer Disease in Infants and Children
In Sheol Park2, Nam Su Kim2, Poong Man Jung1
1Department of Pediatric Surgery, Hanyang University College of Medicine, Seoul,Kore
2Department of Pediatrics, Hanyang University College of Medicine, Seoul,Kore
소아 영역의 소화성 궤양에 대한 임상적 고찰
박인철2, 김남수2, 정품만1
1한양대학교 의과대학 소아외과학교실
2한양대학교 의과대학 소아과학교실
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.
Key Words: Peptic ulcer disease, Children


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