Acute peptic ulcer in childhood. Emergency surgical therapy in 39 cases
S. Dunn, T. R. Weber, J. L. Grosfeld and J. R. Fitzgerald
Acute peptic ulcers occurred in 39 infants and children, 22 girls and 17
boys. Eleven patients were less than one year of age. Peptic ulcers were
secondary to systemic disease or ulcerogenic medications in 34 cases.
Hemorrhage occurred in 27 patients, perforation in 12. Endoscopy was the
most useful diagnostic procedure for hemorrhage. Free air was seen on
abdominal roentgenogram in all perforated patients. Ligation of the ulcer
bed, vagotomy, and pyloroplasty were performed in 25 patients with
bleeding. One patient required total gastrectomy. Simple plication was
performed in nine patients with perforation. Plication was combined with
pyloroplasty and tube duodenostomy in one patient each, and vagotomy and
antrectomy were required in one patient. Operative mortality was 5.2%.
There were two late deaths (Reye's syndrome and burn sepsis). No ulcer has
recurred.