Perforated peptic ulcer in the pediatric population: A case report and literature review

We present a rare occurrence in modern day, western medicine, a case of a nine year old Asian female with a perforated duodenal ulcer. She presented with nausea, anorexia, and abdominal pain. On exam, she was febrile, tachycardic, with evidence of peritonitis. An upright abdominal film revealed a significant amount of pneumoperitoneum. The patient was taken to the operating room and underwent laparoscopic primary repair of a perforated ulcer in the first portion of the duodenum, buttressed with an omental patch. IgG for Helicobacter pylori was positive. We review the differential etiologies for perforation in children, along with the corresponding surgical and medical management of such disease processes.