Shrestha Ashish Lal, Shrestha Anusha
Department of Pediatric Surgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
Department of Pediatrics, Grande International Hospital, Tokha Road, Kathmandu, Nepal.
Case Rep Pediatr. 2021 Nov 18;2021:6304309. doi: 10.1155/2021/6304309. eCollection 2021.
Perforated duodenal ulcer (PDU) is exceedingly uncommon in children. In a child with acute abdomen and pneumoperitoneum, an appendiceal etiology is more often suspected as a likely cause. Failure or delay to diagnose a PDU can result in significant morbidity and even mortality. We report a case of acute abdomen in a girl with PDU with a successful outcome. A 12-year-old school girl presented to emergency room (ER) with acute generalized abdominal pain for 2 days. Clinical examination revealed florid peritonitis, and abdominal radiographs showed free peritoneal air. At emergency laparotomy, PDU was noted with general peritoneal contamination. Omental patch repair and continued supportive care resulted in gradual improvement. PDU is an uncommon cause of peritonitis in children and poses significant challenges in management. Strong suspicion and prompt appropriate intervention is necessary to avoid untoward outcomes.
十二指肠穿孔在儿童中极为罕见。对于患有急腹症和气腹的儿童，更常怀疑病因是阑尾炎。十二指肠穿孔诊断失败或延迟可导致严重的发病率甚至死亡率。我们报告一例患有十二指肠穿孔的女童急腹症病例，结果良好。一名12岁的女学生因急性全腹痛2天就诊于急诊室。临床检查发现明显的腹膜炎，腹部X线片显示有游离腹腔气体。急诊剖腹手术时，发现十二指肠穿孔并伴有广泛的腹腔污染。网膜修补术和持续的支持治疗使病情逐渐好转。十二指肠穿孔是儿童腹膜炎的罕见病因，在治疗上带来重大挑战。必须高度怀疑并迅速采取适当干预措施以避免不良后果。
