Abstract
Duodenal ulcer perforation is a rare disease in children. In many such cases, conservative treatment is chosen for upper gastrointestinal tract perforation. However, depending on the general condition and clinical symptoms, surgical treatment may be needed, and six cases—including the present case— of laparoscopic surgery for duodenal perforation in children have been reported in Japan. We report herein our experience with a 14-year-old boy who experienced duodenal ulcer perforation and underwent laparoscopic perforation plication. The 14-year-old-boy with autism as an underlying disease visited a nearby clinic with a chief complaint of epigastric pain. An analgesic was prescribed and he was under follow-up observation, but symptoms did not improve, and he visited our hospital. Abdominal CT showed free air and accumulated ascites in the peritoneal cavity. Perforation of the duodenal bulb was suspected and symptoms of peritoneal irritation throughout the abdomen were noted, so we performed laparoscopic surgery. Surgical findings included a perforation measuring about 2 mm in the anterior wall of the duodenal bulb, and plication was performed. The postoperative course was favorable, and he was discharged on postoperative day 10.
