HomeRadiologyVol. 56, No. 6 PreviousNext EditorialPeptic Ulcer in ChildhoodPublished Online:Jun 1 1951https://doi.org/10.1148/56.6.889MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractIn studying the literature pertaining to peptic ulcer, one is struck with the relatively small number of contributions concerned with ulcers occurring before the age of fourteen. This may be accounted for by a variety of circumstances.Actually peptic ulcer is probably of less frequent occurrence in children than in adults. When it is present, the patient may be unable to describe his symptoms accurately, and the condition goes unsuspected until bleeding supervenes. The roentgen examination is more difficult, requiring the utmost patience because of the timidity of the child and the pylorospasm which is known to occur so frequently in these young patients. It is probable, also, that the clinician is less alert to the possibility of ulcer because of the many other congenital abnormalities and dietary problems connected with his practice, and in view of the generally accepted opinion that peptic ulcer is rare at so early an age.If one excludes ulcers of the newborn and those developing in connection with exanthematous diseases, gastric ulcer is a very uncommon finding in children between the ages of two and fourteen years. Recently Ingram found reports of only 32 cases, to which he added one of his own. In the same month a similar case was reported by Martin and Saunders. In each of these two instances a roentgenologic diagnosis was made; an ulcer crater was demonstrated and was subsequently shown to have disappeared following medical management. Of the total of 34 gastric ulcers reported in the literature, 16 were discovered on roentgen examination, 5 at autopsy, and 13 at operation. Of the 17 cases reported since 1932, all but 3 were found roentgenologically.It is well authenticated that the usual classical symptoms of gastric ulcer, as seen in adults, are not as a rule present in children, nor is deep epigastric tenderness elicited. Hemorrhage from the stomach is often the first and may be the most important sign of peptic ulceration in infancy. Gross hemorrhage is a serious complication and contributes materially to the poor prognosis.The pathological changes found in these young patients are often more extensive than would be expected. The ulcer crater may be quite large and penetrating, and the incidence of perforation is higher than in adults. Gottlieb, Chu, and Sharlin, among others, have reported perforated gastric ulcer in the newborn.Many theories have been advanced to account for the etiology of peptic ulcer in children but there is no general agreement on this subject. It is said to be more frequent following the acute exanthemata. Cushing showed that many gastric ulcers are of neurogenic origin and demonstrated their occurrence following brain surgery, especially in the cerebellar area.Duodenal ulcer is of much more common occurrence in children than gastric ulcer, as is true also of adults.Article HistoryPublished in print: June 1951 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 56, No. 6 Metrics Altmetric Score PDF download