Perforated Peptic Ulcer in an Adolescent Girl

Schwartz, Shepard; Edden, Yair; Orkin, Þ Boris; Erlichman, Matityahu

doi:10.1097/pec.0b013e31825d21c3

Cited by 17 publications

(13 citation statements)

References 25 publications

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“…The age and gender distribution in our study shows the predominance of PPU in adolescent (100%) boys (93.3%) as similarly observed in previous reports [1,4,8].…”

Section: Discussionsupporting

confidence: 76%

“…One of our patients (6.6%) with a suspected upper gastrointestinal (GI) hemorrhage complained of melena and 1 suffered from epigastric pain radiating to the left shoulder. Similarly, Schwartz et al reported a case of a 14.5-year-old adolescent girl with PPU, who developed abdominal and shoulder pain [1]. Thus, we suggest that melena and epigastric pain radiating to the shoulder should be suspected as a presentation of the upper GI bleeding with peptic ulcer perforation when managing children with peritonitis, particularly with a history of PUD or dyspepsia.…”

Section: Discussionmentioning

confidence: 99%

“…Although peptic ulcer disease (PUD) is a known cause of paediatric abdominal pain, it is still an uncommon or at least not prevalent disorder among children in Western countries [1][2][3][4][5]. Therefore, more than half of cases of PUD are diagnosed predominantly when complicated.…”

Section: Introductionmentioning

confidence: 99%

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Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas

Baltrūnaitė¹,

Trainavičius²

2015

LietChirur

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ObjectivesPerforated peptic ulcer (PPU) is a rare but life-threatening surgical emergency in childhood. The aim of our study was to analyse the clinical features, diagnosis and management of PPU in children. MethodsThe data of children diagnosed with gastroduodenal PPU at Children's Surgery Department, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos from 1994 to 2012 were reviewed. The patients' age, sex, anamnesis, clinical features, examination results, operative findings and methods, medication therapy and outcomes were assessed. Statistical analysis was performed using MS Excel. Results There were 14 (93.3%) males and one female aged 14 to 18 years (16.3 ± 1.3) included in the study. Twelve patients (80%) were diagnosed with gastric and 3 (20%) with duodenal PPU. Eleven patients (73.3%) had dyspepsia before PPU, of them 4 had a history of peptic ulcer disease. Most patients (46.6%) arrived to the hospital within 6 hours of symptom onset. All presented with severe epigastric pain, 8 (53.3%) with nausea and vomiting. Only one patient (6.6%) complained of melena. One (6.6%) suffered from epigastric pain radiating to the left shoulder. Physical examination revealed positive peritoneal signs in 13 patients (86.6%). Subdiaphragmatic free air was detected in 12 patients (80%). The mean duration of perforation was 34.47 ± 57.41 hours (2-178). Thirteen patients (86.6%) underwent laparotomy, 2 laparoscopic repair. The anterior wall of the prepyloric gastric region was the commonest perforation site (80%). Eight patients (53.4%) had a course of H. pylori eradication therapy. The average hospital stay was 10.6 ± 6.3 days (4-32). Fourteen patients (93.3%) had an uneventful postoperative period, one developed nephrotic range proteinuria. All recovered fully. Klinikinė praktika 39Perforated peptic ulcer in children: diagnosis and treatment ConclusionsGastroduodenal PPU should be suspected in adolescent boys with a sudden onset of severe abdominal pain, positive peritoneal signs, and confirmed by pneumoperitoneum in the plain X-ray. Simple closure and eradication of H. pylori (when infection confirmed) are mandatory for a complete recovery. Key words: gastric ulcer, duodenal ulcer, perforated peptic ulcer, children Darbo tikslasSkrandžio ar dvylikapirštės žarnos opos perforacija yra reta, tačiau gyvybei pavojinga vaikų būklė. Darbo tikslas -išanalizuoti vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų kliniką, diagnostiką ir gydymą. Tyrimo medžiaga ir metodai Atlikta retrospektyvi ligonių, 1994-2012 m. gydytų Vaikų ligoninės VUL SK filialo Vaikų chirurgijos skyriuje, duomenų analizė. Vertinta ligonių amžius, lytis, anamnezė, klinika, fizinio ir instrumentinio ištyrimo duomenys, operacijos radiniai, metodai ir trukmė, medikamentinė terapija ir ankstyvosios komplikacijos. Statistinė duomenų analizė atlikta MS Excel programa. Rezultatai Buvo tirta 15 vaikų: 14 (93,3 %) berniukų ir 1 (6,6 %) mergaitė. Vidutinis ligonių amžius buvo 16,3±1,3 metų. Dvylikai (80 %) ligonių diagnozuota skr...

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“…The age and gender distribution in our study shows the predominance of PPU in adolescent (100%) boys (93.3%) as similarly observed in previous reports [1,4,8].…”

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas

Baltrūnaitė¹,

Trainavičius²

2015

LietChirur

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show abstract

“…Perforated ulcer may also occur in children, sometimes associated with other conditions. Albeit rare, it should not be forgotten as a possible cause of acute‐onset pain or otherwise unexplained abdominal symptoms.…”

Section: Resultsmentioning

confidence: 99%

Strategies to improve the outcome of emergency surgery for perforated peptic ulcer

Søreide

Thorsen

Søreide

2014

Journal of British Surgery

183

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“…It is clear from the literature that perforated peptic ulcer disease is frequently not considered in the differential diagnosis of a child with peritonism leading to delays in management 3 7 8. It is also clear from a large Danish registry report that delays in diagnosing and treating perforated ulcers is associated with poorer outcome, with each hour leading to a 2.4% decreased probability of survival 9…”

Section: Discussionmentioning

confidence: 99%

Atypical presentation of perforated peptic ulcer disease in a 12-year-old boy

Mbarushimana¹,

Morris‐Stiff

Thomas

2014

BMJ Case Reports

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A 12-year-old boy was referred to the surgical unit with 4 h history of severe lower abdominal pain and bilious vomiting. No other symptoms were reported and there was no significant medical or family history. Examination revealed tenderness in the lower abdomen, in particular the left iliac fossa. His white cell count was elevated at 19.6×10(9)/L, with a predominant neutrophilia of 15.8×10(9)/L and a C reactive protein of <0.3 mg/L. An abdominal X-ray revealed intraperitoneal gas and a chest X-ray identified free air under both hemidiaphragms. Subsequent diagnostic laparoscopy identified a perforated duodenal ulcer that was repaired by means of an omental patch. The case illustrates that although uncommon, alternate diagnoses must be borne in mind in children presenting with lower abdominal pain and diagnostic laparoscopy is a useful tool in children with visceral perforation as it avoids treatment delays and exposure to excess radiation.

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Perforated Peptic Ulcer in an Adolescent Girl

Cited by 17 publications

References 25 publications

Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas

Vaikų perforavusių skrandžio ir dvylikapirštės žarnos opų diagnostika ir gydymas

Strategies to improve the outcome of emergency surgery for perforated peptic ulcer

Atypical presentation of perforated peptic ulcer disease in a 12-year-old boy

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