Perforated duodenal ulcer presenting with massive hematochezia in a 30-month-old child

作     者：Na Mi Lee Sin Weon Yun Soo Ahn Chae Byoung Hoon Yoo Seong Jae Cha Byung Kook Kwak 

作者机构：Department of PediatricsCollege of MedicineChung-Ang University Department of General SurgeryCollege of MedicineChung-Ang University Department of RadiologyCollege of MedicineChung-Ang University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2009年第15卷第38期

页      面：4853-4855页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Supported by (in part) The Chung-Ang University Research Grant in 2009 

主　　题：Duodenal ulcer Peptic ulcer perforation Children Hematochezia Hemorrhage 

摘      要：Peptic ulcer disease is uncommon in children and rarely suspected as a cause of abdominal complaints in this age group; the diagnosis is therefore made almost exclusively when complications develop. Peptic ulcer disease is usually not considered in the differential diagnosis of pediatric patients. We present the case of a 30-month-old boy with duodenal perforation due to a peptic ulcer without a known etiology. The patient was admitted through the emergency department due to severe hematochezia and ongoing anemia; he presented with neither abdominal pain nor abdominal distension. There were no medical problems, and no drugs, such as corticosteroids or nonsteroidal anti-inflammatory drugs, had been prescribed or administered recently. We tried to control the active bleeding by medical treatment including arterial embolization, but the active bleeding was not controlled. Finally, an exploratory laparotomy was performed. A discrete anterior perforation with active bleeding of the duodenal wall was found. After the operation, there were no complications and the patient recovered fully.