Advances in pediatric surgery
- Volume 10 Issue 1
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- Pages.22-30
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- 2004
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- 2635-8778(pISSN)
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- 2635-8786(eISSN)
A Clinical Analysis of Complicated Gastroduodenal Ulcer in Children
소아에서의 합병성 위십이지장 궤양
- Jung, Kwang-Yong (Department of Surgery, Chonbuk National University Medical School) ;
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Jeong, Yeon-Jun
(Department of Surgery, Chonbuk National University Medical School) ;
- Kim, Chan-Young (Department of Surgery, Chonbuk National University Medical School) ;
- Yang, Doo-Hyun (Department of Surgery, Chonbuk National University Medical School) ;
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Kim, Jae-Chun
(Department of Surgery, Chonbuk National University Medical School)
- 정광용 (전북대학교 의과대학 외과학교실) ;
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정연준
(전북대학교 의과대학 외과학교실) ;
- 김찬영 (전북대학교 의과대학 외과학교실) ;
- 양두현 (전북대학교 의과대학 외과학교실) ;
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김재천
(전북대학교 의과대학 외과학교실)
- Published : 2004.06.30
Abstract
A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3(10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27(90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients: adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.