Gastroduodenal perforation in the pediatric population: a retrospective analysis of 20 cases

Yan, Xiang; Kuang, Houfang; Zhu, Zhenchuang; Wang, Haibin; Yang, Jun; Duan, Xufei; Bian, Hongqiang; Zheng, Ning; Chen, Xuyong

doi:10.1007/s00383-018-4420-4

Cited by 16 publications

(18 citation statements)

References 15 publications

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“…Since the symptoms of DUP in the pediatric population are generally not specific, radiological methods may be preferred for diagnosis. In a study conducted by Yan et al, it was reported that 71.4% of patients with DUP were observed to have subdiaphragmatic free air with plain abdominal X-ray (12). Subdiaphragmatic free air was not detected on a plain abdominal X-ray of two patients in our series.…”

Section: Discussioncontrasting

confidence: 55%

Is Duodenal Ulcer Perforation in Adolescents Different from Duodenal Ulcer Perforation in Adults?

Sayan¹,

Mert²,

Öztan

et al. 2021

Iran J Pediatr

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Background: Duodenal ulcer perforations (DUP) are missed in the differential diagnosis of acute abdomen because they are less common in children than in adults. Delay in diagnosis may cause morbidity or even mortality. It was aimed to raise awareness about DUP in adolescent by comparing the data of adolescent cases treated in our clinic with the adult cases' data in the literature. Objectives: We reviewed the clinical characteristics of nine male patients with DUP, ages between 14 and 17 years, admitted to our clinic between January 2007 and June 2020 retrospectively. Literature data on DUP in adults were reviewed. Methods: The obtained data were compared with the data of adult patients in the literature. Results: Patients were reported to have symptoms such as abdominal pain and vomiting that lasted for 1-30 days on average in 8 patients, and nonsteroidal anti-inflamatory drugs were used all patients except 2 patients. There was diffuse tenderness at the abdomen in all of the remaining patients and in 7 patients intraabdominal free air was observed. Perforation was repaired with omentoplasty in all patients. Unlike the adult population, DUP adolescents are more related to NSAID use rather than Helicobacter pylori infection and complicated surgical techniques were not required because the cases were generally not complicated. Conclusions: Although it is rarely seen in adolescents and shows certain differences compared to adult patients, the anamnesis and physical examination of the patients should direct the physicians to the DUP. Differences from adult population should be considered in diagnosis and treatment.

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Section: Discussioncontrasting

confidence: 55%

Is Duodenal Ulcer Perforation in Adolescents Different from Duodenal Ulcer Perforation in Adults?

Sayan¹,

Mert²,

Öztan

et al. 2021

Iran J Pediatr

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“…However, only 2 cases in our study had a history of familial HP infection. Another study reported that the most common cause of duodenal ulcer perforation in children was the use of dexamethasone [ 13 ]. Steroidal anti-inflammatory drugs can stimulate the secretion of gastric acid and pepsin, inhibit the secretion of gastric mucus, and lead to ulcers.…”

Section: Discussionmentioning

confidence: 99%

“…for perforation of duodenal ulcer. If the perforation diameter is large, omental tamponade repair [ 13 , 16 , 17 ] or distal gastric plus bulbar resection and gastrojejunostomy can be performed [ 18 ]. In addition, with the development of endoscopy, more and more endoscopic treatment and endoscopic combined surgery have been reported to treat duodenal ulcer perforation [ 19 – 21 ].…”

Section: Discussionmentioning

confidence: 99%

Experience in diagnosis and treatment of duodenal ulcer perforation in children

et al. 2023

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Background This study aims to summarize our experience in diagnosis and treatment of pediatric duodenal ulcer perforation in a National Center for Children’s Health. Methods Fifty-two children with duodenal perforation hospitalized in Beijing Children’s Hospital Affiliated to Capital Medical University from January 2007 to December 2021 were retrospectively collected. According to the inclusion and exclusion criteria, patients with duodenal ulcer perforation were included in the group. They were divided into the surgery group and the conservative group according to whether they received surgery. Results A total of 45 cases (35 males and 10 females) were included, with a median age of 13.0 (0.3–15.4) years. Forty cases (40/45, 88.9%) were over 6 years old, and 31 (31/45, 68.9%) were over 12 years old. Among the 45 cases, 32 cases (32/45, 71.1%) were examined for Helicobacter pylori (HP), and 25 (25/32, 78.1%) were positive. There were 13 cases in the surgery group and 32 cases in the conservative group, without a significant difference in age between the two groups (P = 0.625). All cases in the surgery group and the conservative group started with abdominal pain. The proportion of history time within 24 h in the two groups was 6/13 and 12/32 (P = 0.739), and the proportion of fever was 11/13 and 21/32 (P = 0.362). The proportion of pneumoperitoneum in the surgery group was higher than that in the conservative group (12/13 vs. 15/32, P = 0.013). The fasting days in the surgery group were shorter than those in the conservative group (7.7 ± 2.92 vs. 10.3 ± 2.78 days, P = 0.014). There was no significant difference in the total hospital stay (13.6 ± 5.60 vs14.8 ± 4.60 days, P = 0.531). The operation methods used in the surgery group were all simple sutures through laparotomy (9 cases) or laparoscopy (4 cases). All patients recovered smoothly after surgery. Conclusion Duodenal ulcer perforation in children is more common in adolescents, and HP infection is the main cause. Conservative treatment is safe and feasible, but the fasting time is longer than the surgery group. A simple suture is the main management for the surgery group.

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“…Se reporta una mortalidad del 8-25 % en la población general 6,7 . En una revisión de 20 años realizada por Hua MC y colaboradores encontraron que la UDP se presentó en adolescentes entre 12-15 años, con mayor prevalencia en el sexo masculino, como ocurrió en nuestro caso 8,9,10 .…”

Section: Discussionunclassified

Tratamiento laparoscópico de úlcera duodenal perforada mediante parche de Graham en un paciente pediátrico

Romero-Espitia

Villamizar

Pedraza³

et al. 2022

Rev Colomb Cir

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Introducción. La úlcera duodenal perforada es una entidad de etiología no clara que rara vez ocurre en la población pediátrica. Generalmente se diagnostica de manera intraoperatoria y el tratamiento ideal incluye el uso del parche de epiplón o de ser necesario, la resección quirúrgica. Caso clínico. Se presenta un paciente de 12 años con abdomen agudo y diagnóstico tomográfico prequirúrgico de úlcera duodenal perforada, tratado por vía laparoscópica con drenaje de peritonitis y parche de Graham. La evolución y el seguimiento posterior fueron adecuados. Discusión. La úlcera duodenal perforada es una entidad multifactorial, en la que se ha implicado el Helicobacter pylori. El diagnóstico preoperatorio es un reto y el tratamiento debe ser quirúrgico. Conclusiones. Cuando se logra establecer el diagnóstico preoperatorio, se puede realizar un abordaje laparoscópico y el uso del parche de Graham cuando las úlceras son menores de dos centímetros.

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Gastroduodenal perforation in the pediatric population: a retrospective analysis of 20 cases

Cited by 16 publications

References 15 publications

Is Duodenal Ulcer Perforation in Adolescents Different from Duodenal Ulcer Perforation in Adults?

Is Duodenal Ulcer Perforation in Adolescents Different from Duodenal Ulcer Perforation in Adults?

Experience in diagnosis and treatment of duodenal ulcer perforation in children

Tratamiento laparoscópico de úlcera duodenal perforada mediante parche de Graham en un paciente pediátrico

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