|
1
|
Yadav SK, Gupta V, El Kohly A, Al Fadhli W. Perforated duodenal ulcer: a rare complication of deferasirox in children. Indian J Pharmacol 2014; 45:293-4. [PMID: 23833377 PMCID: PMC3696305 DOI: 10.4103/0253-7613.111901] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/17/2012] [Accepted: 02/26/2013] [Indexed: 12/25/2022] Open
Abstract
Duodenal ulcer perforation in pediatric age group is an uncommon entity; hence, it is not usually considered in the differential diagnosis of acute abdomen in these patients. It is important for the emergency physician to consider perforated peptic ulcer in the differential diagnosis of children presenting with acute abdominal pain, gastrointestinal bleeding, or shock. We report a 6½-year-old male child with thalassemia major who presented to emergency room with an acute abdomen and shock, who was subsequently found to have a perforated duodenal ulcer, probably related to use of oral chelating agent, deferasirox. Although, gastrointestinal symptoms like nausea, vomiting, and abdominal pain has been mentioned as infrequent adverse event in the scientific product information of deferasirox, in our current knowledge this is the first case report of perforated duodenal ulcer after oral deferasirox. The severity of this event justifies the reporting of this case. This patient had an atypical presentation in that there were no signs or symptoms of peptic ulcer disease before perforation and shock he was successfully managed with open surgery after initial resuscitation and stabilization of his general condition.
Collapse
|
|
2
|
HAYAKAWA M, MORISE K, SUGITO T, UMEDA T, UCHIDA K, OKA Y, KUROKAWA S, KUSAKABE A, TACHINO F, ANDO T, SAKAI T, HATTORI T, KANAYAMA K, KUSUGAMI K, CHIN K, ITO S, KONAGAYA T, KOJIMA K, HIKI Y. Peptic Ulcer in Infants: Three Case Reports and a Review of the Japanese Literature. Dig Endosc 2007. [DOI: 10.1111/j.1443-1661.1990.tb00339.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Makoto HAYAKAWA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Kimitomo MORISE
- **First Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Aichi, Japan
| | - Tetsuaki SUGITO
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Takashi UMEDA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Kiyoshi UCHIDA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Youji OKA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Susumu KUROKAWA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Atsuhiko KUSAKABE
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Fumio TACHINO
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Takahumi ANDO
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Toru SAKAI
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Tatsuo HATTORI
- ***Department of Pediatric Surgery, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Kazuhiro KANAYAMA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Kazuo KUSUGAMI
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Kenshou CHIN
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Shingo ITO
- ****Department of Gastroenterology, Shizuoka Social Welfare Hospital, Shizuoka, Japan
| | - Toshihiro KONAGAYA
- *Department of Internal Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan
| | - Kunihiko KOJIMA
- *****Department of Pediatrics, Kitasato University, Kanagawa, Japan
| | - Yoishiki HIKI
- ******Department of Surgery, Kitasato University, Kanagawa, Japan
| |
Collapse
|
|
4
|
Abstract
We report a retrospective review of peptic ulcer disease (PUD) in children seen at Children's Hospital of Michigan, over 10 years (1971-1980). Of the 61 included, 31 had primary ulcers and 30 had stress ulcers. The diagnosis was made by either barium meal or endoscopy, at surgery, or at autopsy. Stress ulcers were commoner in children less than 4 years of age and were precipitated by various conditions leading to shock. The majority of these patients required surgery for perforation or bleeding. Primary ulcers were more common in children older than 4 years. The most common presenting symptoms in this group were abdominal pain and gastrointestinal bleeding. The majority of patients with primary PUD received medical therapy in the form of antacids and/or cimetidine. In one-third of these patients, surgery was necessary for complications such as intractable pain, perforation, or massive recurrent hemorrhage.
Collapse
|