Clinical and histological features of duodenal ulcer in children and adolescents

• Published in: Jornal de pediatria Vol. 80; no. 4; pp. 321 - 325
• Main Authors: Kawakami, Elisabete, Machado, Rodrigo S, Fonseca, Jacqueline A, Patrício, Francy R S
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil 01.07.2004
• Subjects: Adolescent; Child; Child, Preschool; Chronic Disease; Duodenal Ulcer - diagnosis; Duodenal Ulcer - microbiology; Duodenal Ulcer - pathology; Duodenitis - diagnosis; Duodenitis - microbiology; Duodenitis - pathology; Female; Gastritis - diagnosis; Gastritis - microbiology; Gastritis - pathology; Helicobacter Infections - diagnosis; Helicobacter Infections - microbiology; Helicobacter Infections - pathology; Helicobacter pylori - isolation & purification; Humans; Male; Prospective Studies
• ISSN: 0021-7557
• DOI: 10.2223/1207

To evaluate clinical and histological features of duodenal ulcer in children and adolescents. 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. 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, 74.4%), vomiting (30/43, 69.8%), postprandial fullness (23/43, 53.5%), weight loss (22/43, 51.2%), and abdominal tenderness (19/43, 44.2%). Upper gastrointestinal bleeding occurred in 19/43 (44.2%), whereas anemia occurred in (21/43, 48.8%). Helicobacter pylori infection was detected in 41/43 (95.3%). All infected patients presented acute chronic gastritis in antrum, with lymphomononuclear infiltrate predominance in 92% of them. Eradication of the bacterium occurred in 68.3%. Ulcer healing occurred in all eradicated patients and in 89% of non-eradicated patients. Duodenal ulcer was associated with chronic gastritis due to Helicobacter pylori in the majority of patients. Many complications occurred, especially upper digestive bleeding.