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Emergency Surgical Therapy in 39 Cases

Stephen Dunn, MD; Thomas R. Weber, MD; Jay L. Grosfeld, MD; Joseph R. Fitzgerald, MD

Arch Surg. 1983;118(5):656-660.

Abstract
• 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.

(Arch Surg 1983;118:656-660)

Author Affiliations
From the Sections of Pediatric Surgery (Drs Dunn, Weber, and Grosfeld) and Pediatric Gastroenterology (Dr Fitzgerald), Indiana University School of Medicine, and the Department of Surgery, James Whitcomb Riley Hospital for Children, Indianapolis.

Footnotes
Accepted for publication Jan 3, 1983.

Read before the 90th annual meeting of the Western Surgical Association, Kansas City, Mo, Nov 16, 1982.

Reprint requests to Department of Pediatric Surgery, J. W. Riley Hospital for Children, 702 Barnhill Dr, Indianapolis, IN 46223 (Dr Grosfeld).

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