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Article: Long-Term Follow-Up Of Childhood Duodenal Ulcers

TitleLong-Term Follow-Up Of Childhood Duodenal Ulcers
Authors
Issue Date1997
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jpedsurg
Citation
Journal Of Pediatric Surgery, 1997, v. 32 n. 11, p. 1609-1611 How to Cite?
AbstractPurpose: This Study Reports The Long-Term Results In Children Who Nave Duodenal Ulcers Diagnosed By Endoscopy Who Were Treated With H2-Receptor Antagonist. Methods: The Medical Records Of 32 Children Admitted Into The Queen Mary Hospital With Endoscopically Proven Duodenal Ulcers Between 1975 And 1988 Were Reviewed To Evaluate The Long-Term Outcome Of Childhood Duodenal Ulcers After Initial Treatment With H2-Receptor Antagonist (H2ra). Follow-Up Details Were Updated And Patients Who Had Been Lost To Follow-Up Were Recalled. The Age Of The 22 Boys And 10 Girls At The Time Of Diagnosis Of The Ulcers Ranged From 3 To 16 Years (Mean, 11.8 Yrs). The Duration Of Follow-Up Ranged From 8.5 To 21 Years (Mean, 11.6 Yrs). Results: Their Primary Presentations Included Epigastric Pain (N = 9, 28.0%); Nonsteroidal Antiinflammatory Drug (Nsaid)-Induced Gastrointestinal Bleeding (Gib, N = 6, 18.7%); Unprovoked Gib (N = 12, 37.5%); Perforation (N = 4, 12.5%); And Pyloric Obstruction (N = 1, 3.0%). All 13 Patients Who Had Nsaid-Induced Ulcers (Pain And Bleeding) Responded To H2ra Therapy And Required No Further Treatment. All 14 Patients Who Had Unprovoked Ulcers Who Presented With Pain Or Bleeding Did Not Respond To H2ra Treatment. Ulcer Healing Was Achieved Only After Eradication Of Helicobacter Pylori With Antibiotics (N = 8) Or Definitive Surgery Involving Either Truncal Vagotomy Aria Pyloroplasty (Vp, N = 4) Or Proximal Gastric Vagotomy (Pgv, N = 2). The Patient Who Had Gastric Outlet Obstruction Had Vagotomy And Antrectomy. All Four Patients Who Had Perforation Were Initially Treated With Patch Repair, But Two Had Persistent Ulceration Despite H2ra Treatment And Required Pgv. Complications Developed In None Of The Four Patients Who Had Pgv, Whereas Two Of The Four Patients With Vp Had Problems (Diarrhea, N = 1; Bezoar Obstruction, N = 1). Conclusions: Unprovoked Childhood Duodenal Ulcer Is Associated With Significant Long-Term Morbidity And Requires Continued Follow-Up. The Majority Of The Ulcers Are Resistant To H2ra Treatment Alone And Ultimately Require Either Eradication Of H Pylori Or Surgery. In The Absence Of Obstruction, Pgv May Be Enough To Resolve The Ulcer Diathesis.
Persistent Identifierhttp://hdl.handle.net/10722/220769
ISSN
2015 Impact Factor: 1.733
2015 SCImago Journal Rankings: 0.802
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, KLen_US
dc.contributor.authorTam, PKHen_US
dc.contributor.authorSaing, Hen_US
dc.date.accessioned2015-10-16T08:27:49Z-
dc.date.available2015-10-16T08:27:49Z-
dc.date.issued1997-
dc.identifier.citationJournal Of Pediatric Surgery, 1997, v. 32 n. 11, p. 1609-1611en_US
dc.identifier.issn0022-3468-
dc.identifier.urihttp://hdl.handle.net/10722/220769-
dc.description.abstractPurpose: This Study Reports The Long-Term Results In Children Who Nave Duodenal Ulcers Diagnosed By Endoscopy Who Were Treated With H2-Receptor Antagonist. Methods: The Medical Records Of 32 Children Admitted Into The Queen Mary Hospital With Endoscopically Proven Duodenal Ulcers Between 1975 And 1988 Were Reviewed To Evaluate The Long-Term Outcome Of Childhood Duodenal Ulcers After Initial Treatment With H2-Receptor Antagonist (H2ra). Follow-Up Details Were Updated And Patients Who Had Been Lost To Follow-Up Were Recalled. The Age Of The 22 Boys And 10 Girls At The Time Of Diagnosis Of The Ulcers Ranged From 3 To 16 Years (Mean, 11.8 Yrs). The Duration Of Follow-Up Ranged From 8.5 To 21 Years (Mean, 11.6 Yrs). Results: Their Primary Presentations Included Epigastric Pain (N = 9, 28.0%); Nonsteroidal Antiinflammatory Drug (Nsaid)-Induced Gastrointestinal Bleeding (Gib, N = 6, 18.7%); Unprovoked Gib (N = 12, 37.5%); Perforation (N = 4, 12.5%); And Pyloric Obstruction (N = 1, 3.0%). All 13 Patients Who Had Nsaid-Induced Ulcers (Pain And Bleeding) Responded To H2ra Therapy And Required No Further Treatment. All 14 Patients Who Had Unprovoked Ulcers Who Presented With Pain Or Bleeding Did Not Respond To H2ra Treatment. Ulcer Healing Was Achieved Only After Eradication Of Helicobacter Pylori With Antibiotics (N = 8) Or Definitive Surgery Involving Either Truncal Vagotomy Aria Pyloroplasty (Vp, N = 4) Or Proximal Gastric Vagotomy (Pgv, N = 2). The Patient Who Had Gastric Outlet Obstruction Had Vagotomy And Antrectomy. All Four Patients Who Had Perforation Were Initially Treated With Patch Repair, But Two Had Persistent Ulceration Despite H2ra Treatment And Required Pgv. Complications Developed In None Of The Four Patients Who Had Pgv, Whereas Two Of The Four Patients With Vp Had Problems (Diarrhea, N = 1; Bezoar Obstruction, N = 1). Conclusions: Unprovoked Childhood Duodenal Ulcer Is Associated With Significant Long-Term Morbidity And Requires Continued Follow-Up. The Majority Of The Ulcers Are Resistant To H2ra Treatment Alone And Ultimately Require Either Eradication Of H Pylori Or Surgery. In The Absence Of Obstruction, Pgv May Be Enough To Resolve The Ulcer Diathesis.en_US
dc.languageengen_US
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/jpedsurgen_US
dc.relation.ispartofJournal Of Pediatric Surgeryen_US
dc.titleLong-Term Follow-Up Of Childhood Duodenal Ulcersen_US
dc.typeArticleen_US
dc.identifier.emailTam, PKH:paultam@hkucc.hku.hk-
dc.identifier.authorityTam, PKH=rp00060-
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0022-3468(97)90464-4-
dc.identifier.pmid9396537-
dc.identifier.scopuseid_2-s2.0-0030720028-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030720028&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume32-
dc.identifier.issue11-
dc.identifier.epage1609-
dc.identifier.epage1611-
dc.identifier.isiWOS:A1997YF52300021-

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