Gastroduodenal perforation in the pediatric population: a retrospective analysis of 20 cases
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The aim of this study was to investigate the pathogenesis, symptoms and individualized surgical management in pediatrics with gastroduodenal perforation (GDP).
Patients diagnosed with GDP from January 2013 to December 2016 in our hospital were collected and divided into gastric perforation (GP) group and duodenal perforation (DP) group. Demographics, clinical events, etiological factors, symptoms, the time from symptom onset to operation, intraoperative findings and surgical procedures were analyzed. Follow-ups including ulcer, perforations occurrence, and digestive symptoms were carried out by out-patient review or telephones.
A total of 20 patients aged from 3 months to 14 years were enrolled in this study. The average age, main clinical presentations, size of perforations and operating time between two groups had no difference. The male to female ratio in DP group was higher than GP (P < 0.05). The high risk factor for DP was the use of dexamethasone, and for GP was HP infection. The most common site of perforation in DP group was duodenal bulb, and in GP group was pylorus area. Simple suture is the main management for both DP and GP, but distal gastrectomy combined with gastrojejunal Roux-en-Y anastomosis may be an alternative procedure for large perforation with diameter > 2 cm. The length of hospital days in GP group is shorter than DP group (P < 0.05). For follow-up, no patients had digestive symptoms.
The general condition had no difference between GP and DP patients. But the risk factors and surgical repair differ depending on the patient’s fundamental illness and the complexity of the perforation.
KeywordsGastroduodenal perforation Peptic ulcer Laparoscopy-assisted simple suture H. pylori
This study was funded by a grant from Health and Family Planning Commission of Wuhan (No. WX14C53).
Compliance with ethical standards
Conflict of interest
Xueqiang Yan has received research grants from Health and Family Planning Commission of Wuhan. All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Wuhan Children’s Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Written informed consent was obtained from all patients or guardians enrolled in this study.