Retrospective study of 42
children with gastric ulcer
Hou L-Y, Yan H-M, Li S-T, Wang Ch-L, Ji Zh-Y
Beijing
Children’s Hospital, Beijing, China
Objective: To investigate the
clinical manifestations and implication of Helicobacter pylori (Hp) with gastric
ulcers in children.
Methods: All 42 children with
gastric ulcers diagnosed by flexible gastroscopy. Biopsy was reviewed for
33 cases. Detected Hp use rapid urease testing (RUT) on gastric biopsy and
biopsy specimens with Giemsa stain.
Results: 2154 children were examined by flexible
gastroscopy between January 1991 and December 2000 in Beijing Children’s
Hospital. Diagnosed 236 cases with ulcer disease, 42 cases with gastric
ulcers, 191 cases with duodenal ulcers, 3 cases with compound ulcers. The detectable
rate of gastric ulcers were 1.95% (42/2154) and 17.80%(42/236) in
gastroscopy and ulcer disease, respectively. Duodenal ulcer and gastric
ulcer ratio was 4.55: 1. There were 36 boys and 6 girls among 42 children
with gastric ulcers. Their mean age was 8.41±3.88
(from 11 month and 14 years). 8 children (19.05%) had family history of
ulcers. Primary ulcers were diagnosed in 35 patients (83.33%) and secondary
ulcers in 7 (16.67%). Smptoms of gastric ulcers: 38 patients (90.48%) had
epigastric abdominal pain; 27 patients (64.29%) had acute or chronic
gastrointestinal blood loss (hematemesis hematochezia, melena); 26 patients
(61.90%) had vomiting; 18 patients (42.86%) had anorexia; 9 patients
(21.43%) had anemia; 7 patients (6.67%) had acid regurgitation. Complications:
27 cases had gastrointestinal hemorrhage; 1 case had obstruction; no case
had penetration. The region of gastric ulcers occurrence: gastric antrum:
17 cases; body of stomach: 9 cases; gastric angle: 7 cases; pyloric canal:
5 cases; fundus of stomach: 5 cases. The positive rate of Hp was 42.42%
(14/33).
Conclusions: The morbidity of
gastric ulcer is lower than duodenal ulcer. Less than half of the gastric
ulcers were associated with the infection of Hp.