Perforated Duodenal Ulcer in a Young Child: An Uncommon Condition

Yadav, Rohit Prasad; Agrawal, Chandra Shekhar; Gupta, Rakesh Kumar; Rajbansi, S; Bajracharya, Amir; Adhikary, Shailesh

doi:10.31729/jnma.237

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…[ 16 ] Bleeding from acute ulceration of the gastric mucosa may contribute to hypotension, anemia, and possible perforation, peritonitis, and septic shock. [ 17 ] Finally, the acute decrease in gastric emptying may put the burn patient at risk for aspiration during periods of sedation, airway instrumentation, or changes in mental status. [ 18 ]…”

Section: Systemic Effects Of Burn Injurymentioning

confidence: 99%

Pediatric burn injuries

Krishnamoorthy

Ramaiah

Bhananker

2012

Int J Crit Illn Inj Sci

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Pediatric burns comprise a major mechanism of injury, affecting millions of children worldwide, with causes including scald injury, fire injury, and child abuse. Burn injuries tend to be classified based on the total body surface area involved and the depth of injury. Large burn injuries have multisystemic manifestations, including injuries to all major organ systems, requiring close supportive and therapeutic measures. Management of burn injuries requires intensive medical therapy for multi-organ dysfunction/failure, and aggressive surgical therapy to prevent sepsis and secondary complications. In addition, pain management throughout this period is vital. Specialized burn centers, which care for these patients with multidisciplinary teams, may be the best places to treat children with major thermal injuries. This review highlights the major components of burn care, stressing the pathophysiologic consequences of burn injury, circulatory and respiratory care, surgical management, and pain management of these often critically ill patients.

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Section: Systemic Effects Of Burn Injurymentioning

confidence: 99%

Pediatric burn injuries

Krishnamoorthy

Ramaiah

Bhananker

2012

Int J Crit Illn Inj Sci

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“…Although the prevalence of the H. pylori infection is in decline in west, it is still considered high among Asian and African population. [5][6][7][8] Paediatric patients most commonly acquire the infection from their mothers, likely as a result of sharing utensils, overcrowding and sharing beds with children. H. pylori can be diagnosed by serology, stool antigen, urea breath tests etc.…”

Section: Discussionmentioning

confidence: 99%

“…H. pylori can be diagnosed by serology, stool antigen, urea breath tests etc. 5,7,8 However Urease test and histopathological confirmation remains the most accurate. First line of management is by using two antibiotics in conjunction with Proton pump inhibitors for 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

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A rare case of spontaneous gastric perforation in an adolescent

Vasuki

Moothedath

2018

Int Surg J

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Incidence of Peptic ulcer perforation in children and adolescents are very rare. Perforated gastric ulcer is extremely rare with only handful of cases reported worldwide in the same age group. Pneumoperitoneum and peritonitis due to gastric perforation is a very rare presentation in children and adolescents and it can often be overlooked with disastrous consequences. Even though in young patients, peptic ulcerations can happen in association with H. pylori infection, secondary to medications like non-steroidal anti-inflammatory agents, corticosteroids, rarely due to Zollinger Ellison syndrome, related to stress, post burns or head trauma it is seldom common. Among perforations gastric perforation is very rare. Here we discuss a case of 15-year-old school student who presented with acute abdominal pain and features of peritonitis which we initially thought probably due to perforated appendix but turned out to be a gastric perforation. Plain radiograph of the abdomen showed pneumoperitoneum. When an emergency midline laparotomy was performed, we found a perforation in gastric antrum anteriorly with peritonitis which was treated by thorough decontamination and Graham's live omental patch closure. H. Pylori tests were negative. At a time when acute presentation of peptic ulcerations or perforation as its complication is decreasing in incidence worldwide, this case has come as an eye opener. Thus, perforated gastric/duodenal ulcer in pediatric and young adult patient should not be overlooked in a young patient presenting with acute abdomen. Many times, there is no clear etiology and then it is spontaneous perforation. Emergency surgical management is the preferred mode of treatment.

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“…Most of the cases with primary duodenal ulcers are related to Helicobacter pylori infection. Predisposing factors such as serious stressful conditions, systemic diseases, head traumas, burns, surgical interventions, and drug use (NSAIDs) accompany secondary duodenal ulcers (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%