Negash Samuel, Jembere Tarekeng, Abera Gersam, Kedir Elias, Eshetu Beza
Department of Pediatrics, Jimma University, Ethiopia.
Department of Pediatrics, Jimma University, Ethiopia.
Int J Surg Case Rep. 2023 Apr;105:108086. doi: 10.1016/j.ijscr.2023.108086. Epub 2023 Mar 29.
Gastric outlet obstruction (GOO) is a spectrum of congenital and acquired conditions that prevent the passage of gastric contents beyond the proximal duodenum. Peptic ulcer disease (PUD), which causes GOO, is extremely rare in children, with an incidence of 1 per 100,000 live births. Because of the rarity of the disease in children, we report a case of GOO due to PUD in a 5-year-old child.
We report a case of an acquired GOO due to PUD in a 5-year-old female child who presented with vomiting, weight loss, and epigastric pain of 3 months' duration. Her diagnosis of GOO secondary to PUD was made by upper gastrointestinal (UGI) endoscopy despite a negative stool H. pylori antigen. She was managed with proton pump inhibitor (PPI), which results in improvement of signs and symptoms. She has been on follow-up for the last 6 months and has remained asymptomatic.
H. pylori-positive GOO is successfully treated with PPI and antibiotic therapy. The role of H. pylori therapy in PUD-related GOO is less clear, although eradication is warranted as a primary intervention.
GOO secondary to PUD may occur in the absence of Helicobacter pylori infection (HPI). Our patient demonstrated response to medical management in the acute phase of ulceration.
胃出口梗阻（GOO）是一系列先天性和后天性疾病，可阻止胃内容物通过十二指肠近端。导致GOO的消化性溃疡病（PUD）在儿童中极为罕见，活产发病率为十万分之一。由于该病在儿童中罕见，我们报告一例5岁儿童因PUD导致的GOO病例。
我们报告一例5岁女童因PUD导致的后天性GOO，她出现呕吐、体重减轻和持续3个月的上腹部疼痛。尽管粪便幽门螺杆菌抗原检测为阴性，但通过上消化道（UGI）内镜检查确诊为PUD继发GOO。她接受质子泵抑制剂（PPI）治疗，症状体征有所改善。在过去6个月里她一直在接受随访，且一直无症状。
幽门螺杆菌阳性的GOO通过PPI和抗生素治疗可成功治愈。幽门螺杆菌治疗在PUD相关GOO中的作用尚不清楚，尽管根除作为主要干预措施是必要的。
PUD继发的GOO可能在无幽门螺杆菌感染（HPI）的情况下发生。我们的患者在溃疡急性期对药物治疗有反应。
