Duodenal ulcer in South Indian children

Gahukamble, D. B.; Fenn, A.; Devadatta, Joe; Mammen, K. E.

doi:10.1016/0002-9610(83)90191-5

Cited by 5 publications

(5 citation statements)

References 10 publications

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“…The number of our patients is small but the absence of complications suggests good tolerance of truncal vagotomy and drainage by children and should be the operation of choice, as noted by others. 1,3,13 Highly selective vagotomy, though effective in ulcer management, is as a matter of preference rarely performed in our institution. 14 As in India, 3 the traditional African diet is bulky so that the small gastric reservoir created by gastric resection may cause severe nutritional problems: gastric resection is therefore rarely performed for peptic ulcer disease in children in our institution.…”

Section: Discussionmentioning

confidence: 97%

“…10 In developed countries, perforation and bleeding are the most common complications 1 but, as in the present report, pyloric stenosis occurs frequently in India. 3 The problem of diagnosis of peptic ulcer disease in children is further compounded by the fact that barium meal examination is reliable only in a small number of cases as barium may be trapped in a gastric or duodenal fold, giving the appearance of an ulcer crater. 1,2,5,11 Upper gastro-intestinal endoscopy, which is now a safe and effective procedure in children, 9,12 is therefore indicated in patients with recurrent abdomnal pain and a negative or equivocal barium meal study.…”

Section: Discussionmentioning

confidence: 99%

“…3 This re¯ects the availability of sensitive diagnostic facilities, especially endoscopy, in the industrialised nations. In one large series of 110 patients, the mean age at presentation was 11.3 years with only 46% having symptoms before 10 years of age and 15% before 6 years.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 However, there are few reports of this disease in children in developing countries, 3 perhaps due to a lack of awareness and a lack of endoscopy facilities in many centres. This is a report of the experience of peptic ulcer disease in Zaria, Nigeria.…”

Section: Introductionmentioning

confidence: 96%

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Peptic ulcer disease in childhood in Zaria, Nigeria

Ameh

1999

Annals of Tropical Paediatrics

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Over a 10-year period in a busy paediatric surgical unit, six children were operated upon for peptic ulcer disease, four of whom presented with complications (pyloric stenosis, two; perforation, one; bleeding, one). Truncal vagotomy with a drainage procedure was the operation of choice in five of the children in whom there were no complications. One child suspected of having Zollinger-Ellison syndrome had recurrence of symptoms. Symptoms of peptic ulcer disease in children are non-specific, and in our environment such symptoms are frequently considered to be due to parasitic infestation. Barium meal is not very sensitive in diagnosis in children, and the relative lack of availability of endoscopic services limits pre-operative diagnosis. It is suggested that peptic ulcer disease be considered in children who have persistent or recurrent abdominal pain of obscure aetiology.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Peptic ulcer disease in childhood in Zaria, Nigeria

Ameh

1999

Annals of Tropical Paediatrics

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“…Hematêmese isolada sem dor abdominal ocorreu em 15,8% (3/19) dos pacientes, mas pode ocorrer em até 25% dos casos 21 . Houve apenas um paciente com obstrução pilórica, enquanto que estudo realizado no sul da Índia em 1983 22 refere 8/12 pacientes com estenose pilórica em 29 pacientes com úlcera duodenal em 18 anos; outros autores referem taxas bem menores.…”

Section: Discussionunclassified

Clinical and histological features of duodenal ulcer in children and adolescents

Kawakami¹,

Machado²,

Fonseca³

et al. 2004

J Pediatr (Rio J)

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Objective: To evaluate clinical and histological features of duodenal ulcer in children and adolescents.Methods: Forty-three children with duodenal ulcer were prospectively and consecutively evaluated in a 6 year period (7.2 patients per year). Evaluation included clinical questionnaire focused on dyspeptic symptoms, physical examination, and digestive endoscopy with gastric biopsies for histological examination and Helicobacter pylori detection.Results: Diagnostic age ranged from 4 years and 8 months to 17 years and 4 months (mean age: 12 years and 4 months). Abdominal pain was the main symptom (39/43, 90.7%), which was epigastric in 31/39, periumbilical in 7/39, and nocturnal in 27/39. Other symptoms were loss of appetite (32/43, 74 ResumoObjetivo: Avaliar as características clínicas e histológicas de crianças e adolescentes com úlcera duodenal.Métodos: Foram avaliadas prospectiva e consecutivamente 43 pacientes com úlcera duodenal ao longo de 6 anos (7,2 pacientes por ano). A avaliação consistiu de questionário clínico de sintomas dispép-ticos, exame físico e endoscopia digestiva com biópsias gástricas para exame histológico e detecção do Helicobacter pylori.Resultados: A idade no diagnóstico variou de 4 anos e 8 meses a 17 anos e 4 meses (mediana = 12 anos e 4 meses ARTIGO ORIGINALGastrite crônica associada à infecção por Helicobacter pylori está presente na grande maioria das crianças com úlcera duodenal primária, havendo consenso para o tratamento de erradicação da bactéria, pela diminuição acentuada do índice de recidivas ulcerosas 1 . A colonização da mucosa gástrica por H. pylori, bacilo gram-negativo, microaerofílico, espiralado, atualmente ocorre em uma minoria das crianças de países desenvolvidos, ao contrário das crianças de países em desenvolvimento, sendo a prevalên-cia até 10 anos de idade de 5-10% e até 80%, respectivamente 2 . Os principais fatores de risco para contrair a infecção são: viver em país em desenvolvimento e ser criança com pais infectados e de baixo poder aquisitivo 3 . A maioria dos pacientes é assintomática, estimando-se que cerca de 15% evoluem para úlcera péptica e 1% para câncer gástrico 4 . Após a instalação da gastrite, a bactéria geralmente persiste por toda a vida, sendo rara a erradicação espontânea. Não há conclusão definitiva a respeito da influência dos fatores de virulência da bactéria, assim como da resposta do hospedeiro ou das condições ambientais que poderiam interferir no curso evolutivo desta afecção.

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Peptic Ulcer Disease in Children

Gryboski¹

1991

Medical Clinics of North America

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Duodenal ulcer in South Indian children

Cited by 5 publications

References 10 publications

Peptic ulcer disease in childhood in Zaria, Nigeria

Peptic ulcer disease in childhood in Zaria, Nigeria

Clinical and histological features of duodenal ulcer in children and adolescents

Peptic Ulcer Disease in Children

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