Hanke S, Göbel P, Weitzel A, Saeger H D, Roesner D
Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Carl Gustav Carus, Technischen Universität Dresden.
Klin Padiatr. 1998 Mar-Apr;210(2):89-93. doi: 10.1055/s-2008-1043857.
Peptic ulcers in infants are rare. We report a 5-year-old boy who was admitted with recurrent bleeding from a huge duodenal ulcer. There were no concomitant disease and no preceding symptoms discovered. The only clinical symptom was bloody stool of light red color what led to diagnostic problems. Upper gastrointestinal bleeding was not considered initially. Short transit time through the gut may suggest a bleeding source within the lower intestine. Gastroscopy was performed delayed. Injection therapy of the ulcer once using fibrin sealant was followed by definite cessation of bleeding. Helicobacter pylori was not found. Hormone producing tumors could be excluded. There was a psycho-social situation of stress recognizable for the infant. The pathogenic mechanism of peptic ulceration due to psycho-social stress is unknown and somewhat doubtful at all. Peptic ulcer disease in infants and children should more often be considered when dealing with diffuse abdominal pain or with gastrointestinal bleeding.
婴儿消化性溃疡很少见。我们报告一名5岁男孩，因巨大十二指肠溃疡反复出血入院。无伴随疾病，未发现前驱症状。唯一的临床症状是淡红色血便，这导致了诊断问题。最初未考虑上消化道出血。肠道通过时间短可能提示出血源在下段肠道。胃镜检查延迟进行。使用纤维蛋白密封剂对溃疡进行了一次注射治疗，随后出血明确停止。未发现幽门螺杆菌。可排除激素分泌肿瘤。该婴儿存在可识别的心理社会应激情况。心理社会应激导致消化性溃疡的发病机制尚不清楚，而且根本有些可疑。在处理弥漫性腹痛或胃肠道出血时，应更频繁地考虑婴儿和儿童的消化性溃疡疾病。
