A 45-year experience with surgical treatment of peptic ulcer disease in children

K. Azarow, P. Kim, B. Shandling, S. Ein

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Peptic ulcer disease (PUD) requiring surgical treatment has become rare with the availability of modern medical management. A retrospective study of all patients who required operations for PUD between 1949 and 1994 (n = 43) was done. The patients were classified into 3 groups: A (n = 38): pre- histamine-2 (H2) blocker era (1949-1975); B (n = 3): pre-hydrogen-potassium (H-K+) ATPase inhibitor era (1976-1988); C (n = 2): H-K+ ATPase inhibitor era (19891994). Data, analyzed using χ2 analysis (P < .01), included preoperative medical therapy, surgical indications, type of operation performed, complications, and postoperative medical therapy. The indication for surgery in group A was bleeding (26), perforation (8), or obstruction (4); in group B the indication was obstruction (2) or perforation (1); in group C the indication was obstruction (1) or bleeding (1). The incidence of obstruction as an indication for surgery did not differ among the groups (P < .01). Two of the three patients who had surgery for obstruction in groups B and C had biopsy-proven Helicobacter pylori. The postoperative morbidity rate was lower for groups B and C, although not significantly. The relative mortality among the groups did not change (P > .01). Children with PUD can have complications similar to those of adults with PUD. Since the introduction of H2 antagonists, the recognition and treatment of H pylori, and the use of H-K+ ATPase inhibition, the incidence of operations for bleeding and perforation has decreased dramatically. However, the incidence of surgery for obstruction remains the same.

Original languageEnglish (US)
Pages (from-to)750-753
Number of pages4
JournalJournal of pediatric surgery
Issue number6
StatePublished - Jun 1996
Externally publishedYes


  • Peptic ulcer
  • bleeding
  • obstruction
  • perforation
  • surgery

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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