Perforated gastric ulcer in the child: a rare complication, a case report

Bott, L.; Vara, D.; Missotte, I.; Ménager, C.

Archives de Pediatrie Organe Officiel de la Societe Francaise de Pediatrie 10(1): 31-33

2003


ISSN/ISBN: 0929-693X
PMID: 12818777
Accession: 049887988

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Abstract
Perforated gastric ulcer is unusual in children. We report a case in a girl with an unexpected evolution. A 13-year-old girl was admitted for abdominal pain. She had no particular personal history but her father had a perforated ulcer. On admission she was not painful, her abdomen was soft on palpation. The white blood cell count was 1.7 x 10(3)/mm3. A right pneumoperitoneum was seen on an abdominal X-ray film. Because of her good general status and the normalization of the abdominal X ray film six hours later, no surgical exploration was performed. On the fourth day, a gastrointestinal endoscopy showed an anterior gastric ulcer which was perforated. Biopsies did not isolate H. pylori. The patient was given a treatment with amoxicillin-metronidazole (7 d) and oméprazole (7 weeks). An endoscopic control, one month later, showed a total healing of the gastric ulcer. Peptic ulcerations and their complications are underdiagnosed in childhood. This could lead to delay in diagnosis or inappropriate treatment specially in case of perforation.