Duodenal ulcer perforation in a 3-year-old child with lower respiratory tract infection and hyperthyroidism

Abstract

Peptic ulcer disease (PUD) in children remains rare and difficult to diagnose before the onset of complications. We describe a 3-year-old child with perforated duodenal ulcer, associated with lower respiratory tract infection and hyperthyroidism. Upper GI endoscopy revealed three clean based ulcers in the first part of duodenum, erect chest x-ray showed bilateral gas under diaphragm and CT scan confirmed massive pneumoperitoneum. Emergency exploratory laparotomy detected perforation in the anterior wall of duodenum, managed with simple sutural closure. PUD in children is rare and high index of suspicion is required to prevent complications.