The characteristics of 83 giant peptic ulcers in Chinese children: Evaluation and follow-up

Abstract

Background/Aims:Giant peptic ulcers (GPUs) are detrimental for all patients, especially for children. However, few reports have described GPUs in children. This study aims to evaluate the characteristics of GPUs in Chinese children and to identify risk factors.Patients and Methods:We retrospectively analyzed patients at the Children's Hospital of Fudan University from April 2014 to August 2017. Patients with GPUs (>2.0 cm) were included in the study, and the clinical data, pathological characteristics and presence of Helicobacter pylori (H. pylori) infection were analyzed to evaluate the outcomes.Results:A total of 19208 children underwent gastroscopic examinations, and 83 patients with GPUs were enrolled. The mean age of onset for GPU patients was 9.7 ± 3.2 years(range, 1-15). The main complaints were abdominal pain (92.7%), anemia (53%), retching (45.8%), hematochezia (21.7%) and hematemesis (16.9%). With respect to the types of GPU, 68 patients (81.9%) had duodenal ulcers, and 15 patients (18.1%) had gastric ulcers. Compared to the group <6 years of age, the group ≥6 years was more susceptible to GPU (P < 0.05). Among GPU patients, 71.1% of cases were H. pylori (+) (59/83), and 16.9% (14/83) of patients were H. pylori (-). Compared to the H. pylori (-) group, the H. pylori (+) group showed inflammatory activity, atrophy and lymphoid follicular formation in the gastric mucosa (P < 0.05).Conclusions:This study suggests that GPUs are strongly associated with H. pylori infection in Chinese children. Duodenal ulcers are the main type of GPU in patients older than 6 years. Appropriate diagnosis, treatment and follow-up are necessary for children with GPUs.

Gastric Microenvironment—A Partnership between Innate Immunity and Gastric Microbiota Tricks Helicobacter pylori

“…The clinical spectrum of this infection in children varies from asymptomatic to life-threatening conditions, such as peptic ulcer disease [ 21 , 22 ]. Nevertheless, the symptoms in children with H. pylori infection remain unspecific including abdominal pain, nausea, vomiting, heartburn [ 21 , 23 ], and thus the most recent recommendation of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) is to perform the necessary investigation for identifying the underlying cause of the symptoms and not only for assessing the presence of this infection [ 24 ].…”

Gastroesophageal Reflux Disease and Erosive-Ulcerative Lesions of the Gastroduodenal Zone in Schoolchildren of Various Ages in Siberia

“…С одной стороны, это обусловлено высокой распространенностью заболеваний верхних отделов желудочно-кишечного тракта у детей [1][2][3], с другой стороны, отсутствуем положительной динамики эпидемиологических показателей. Как негативный факт следует отметить сохранение уровня распространенности язвенной болезни среди детей [4,5]. Кроме того, в последние годы в детских популяциях стала более острой проблема заболеваний пищевода, в структуре которых отмечается увеличение эрозивного эзофагита, являющегося наиболее тяжелой формой гастроэзофагеальной рефлюксной болезни (ГЭРБ) у детей [6,7].…”