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Case Reports
. 2020 Jul-Dec;17(3 & 4):115-118.
doi: 10.4103/ajps.AJPS_18_20.

Perforated gastric ulcer: An unusual cause of peritonitis in children

Abdelouhab Ammor  1 , Siham Nasri  2 , Maria Rkain  3 , Houssain Benhaddou  1
Affiliations
Case Reports

Perforated gastric ulcer: An unusual cause of peritonitis in children

Abdelouhab Ammor et al. Afr J Paediatr Surg. 2020 Jul-Dec.

Abstract

Perforated gastric ulcer is a particularly rare cause of peritonitis in children. Only few cases have been reported in the literature. It is a serious emergency condition which can be overlooked leading to life-threatening consequences. We report a case of a 12-year-old girl who presented with acute abdominal pain and signs of peritonitis. Surgical exploration found a gastric perforation on the anterior side of the antrum. Primary repair of the perforation was performed after thorough decontamination and taking biopsies from its edges. The post-operative period was uneventful. Helicobacter pylori test was negative. Histopathology result was suggestive of ulceration in the gastric wall and did not isolate H. pylori. Gastro-duodenal ulcer perforation should be considered in the differential diagnosis of children presenting with acute abdomen, especially when imaging showing pneumoperitoneum.

Keywords: Children; gastric ulcer; perforation; peritonitis; pneumoperitoneum.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Erect abdominal X-ray covering the lung bases showing pneumoperitoneum beneath the right and left hemidiaphragm. Short segment of adynamic ileus (sentinel loop)
Figure 2
Figure 2
Axial non-contrast computed tomography of the abdomen showed several locules of free intra-peritoneal air within the upper abdomen, with a large amount of free air along the anterior aspect of the liver surface (yellow arrow) with peri-splenic ascites (green arrow). Normal appearance of the liver and spleen
Figure 3
Figure 3
Axial view of contrast computed tomography scan: Free intra-peritoneal fluid in right para-colic gutters (yellow arrow)
Figure 4
Figure 4
Axial view of contrast computed tomography scan: Free intra-peritoneal fluid is seen also in the left iliac fossa (yellow arrow)
Figure 5
Figure 5
Intraoperative view showing a gastric perforation of nearly 1.5 cm on the anterior side of the antrum
Figure 6
Figure 6
Intra-operative view at the end of surgery after closure of the perforation
See this image and copyright information in PMC

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