Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature
Background: With increasing use of endoscopy in children, peptic ulcer disease (PUD) is being diagnosed more frequently and perforation of PUD is also being reported. However, most such cases are reported in older children and adolescents. We report a rare occurrence of perforated PUD in a young chi...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Indian Pediatrics Case Reports |
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| Online Access: | https://journals.lww.com/10.4103/ipcares.ipcares_264_23 |
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| author | Ruchi Mishra Shivangi Tetarbe Parag Janardhan Karkera Ira Shah |
| author_facet | Ruchi Mishra Shivangi Tetarbe Parag Janardhan Karkera Ira Shah |
| author_sort | Ruchi Mishra |
| collection | DOAJ |
| description | Background:
With increasing use of endoscopy in children, peptic ulcer disease (PUD) is being diagnosed more frequently and perforation of PUD is also being reported. However, most such cases are reported in older children and adolescents. We report a rare occurrence of perforated PUD in a young child associated with the rupture of pseudoaneurysm of gastroduodenal artery (GDA).
Clinical Description:
A 3-year-old boy presented with abdominal pain and nonbilious vomiting, exhibiting peritoneal signs upon examination. An X-ray erect abdomen confirmed pneumoperitoneum. During the hospital stay, the patient also developed melaena.
Management and Outcome:
Emergency laparotomy revealed a small perforation between the pylorus and the first part of the duodenum, which was successfully repaired. However, postoperatively, the patient continued to experience massive melaena, accompanied by a significant drop in hemoglobin. Angiography indicated an irregular GDA with a small pseudoaneurysm which was then angioembolized. The patient recovered and was discharged on proton-pump inhibitors. A gastroduodenoscopy after 2 weeks revealed Helicobacter pylori (HP) infection, which was treated as per guidelines.
Conclusion:
This case report underscores the importance of considering perforated PUD in a child with pneumoperitoneum, and HP testing in all children with PUD. Rupture of a pseudoaneurysm of GDA may be a complication of PUD, which if promptly treated, can be life-saving. |
| format | Article |
| id | doaj-art-80d27ae1ad2948d1b6d71f084f02d0f7 |
| institution | Kabale University |
| issn | 2772-5170 2772-5189 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Pediatrics Case Reports |
| spelling | doaj-art-80d27ae1ad2948d1b6d71f084f02d0f72024-12-10T08:52:19ZengWolters Kluwer Medknow PublicationsIndian Pediatrics Case Reports2772-51702772-51892024-11-014421421810.4103/ipcares.ipcares_264_23Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of LiteratureRuchi MishraShivangi TetarbeParag Janardhan KarkeraIra ShahBackground: With increasing use of endoscopy in children, peptic ulcer disease (PUD) is being diagnosed more frequently and perforation of PUD is also being reported. However, most such cases are reported in older children and adolescents. We report a rare occurrence of perforated PUD in a young child associated with the rupture of pseudoaneurysm of gastroduodenal artery (GDA). Clinical Description: A 3-year-old boy presented with abdominal pain and nonbilious vomiting, exhibiting peritoneal signs upon examination. An X-ray erect abdomen confirmed pneumoperitoneum. During the hospital stay, the patient also developed melaena. Management and Outcome: Emergency laparotomy revealed a small perforation between the pylorus and the first part of the duodenum, which was successfully repaired. However, postoperatively, the patient continued to experience massive melaena, accompanied by a significant drop in hemoglobin. Angiography indicated an irregular GDA with a small pseudoaneurysm which was then angioembolized. The patient recovered and was discharged on proton-pump inhibitors. A gastroduodenoscopy after 2 weeks revealed Helicobacter pylori (HP) infection, which was treated as per guidelines. Conclusion: This case report underscores the importance of considering perforated PUD in a child with pneumoperitoneum, and HP testing in all children with PUD. Rupture of a pseudoaneurysm of GDA may be a complication of PUD, which if promptly treated, can be life-saving.https://journals.lww.com/10.4103/ipcares.ipcares_264_23embolizationendovascular therapygastrointestinal hemorrhagehelicobacter pylori infectionpediatricpneumoperitoneum |
| spellingShingle | Ruchi Mishra Shivangi Tetarbe Parag Janardhan Karkera Ira Shah Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature Indian Pediatrics Case Reports embolization endovascular therapy gastrointestinal hemorrhage helicobacter pylori infection pediatric pneumoperitoneum |
| title | Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature |
| title_full | Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature |
| title_fullStr | Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature |
| title_full_unstemmed | Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature |
| title_short | Pyloric Perforation with Gastro-duodenal Artery Pseudo Aneurysm Due to Peptic Ulcer Disease in a Toddler: Case Report with Review of Literature |
| title_sort | pyloric perforation with gastro duodenal artery pseudo aneurysm due to peptic ulcer disease in a toddler case report with review of literature |
| topic | embolization endovascular therapy gastrointestinal hemorrhage helicobacter pylori infection pediatric pneumoperitoneum |
| url | https://journals.lww.com/10.4103/ipcares.ipcares_264_23 |
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