[Peptic ulcer in children: diagnosis and treatment (author's transl)].

Within a period of 14 years 23 children were treated for peptic ulcer (0.039% of all inpatients). Acute ulcers were seen in neonates or after major surgery, and were diagnosed only after perforation or bleeding. Chronic ulcers predominantly occurred after the sixth year. In addition to abdominal pain and colic, perforation and haemorrhage were also seen, the latter occasionally without previous symptoms. Three children were operated on for perforation, two for gastroduodenal haemorrhage. One of them, a neonate, died of septicaemia with subarachnoid haemorrhage. The bleedings were stopped by purse-string suture, the perforations by oversewing in two, local excision in one. Follow-up examination was undertaken in 14 of the 22 surviving children six months to 12 years after the initial manifestation. None had a recurrence. It is concluded that peptic ulcer is more frequent in children than is generally supposed. Treatment is mainly conservative. In case of perforation or haemorrhage the least possible surgical intervention should be practised.