Abstract
A five-year-old male was referred to our hospital because of a high fever and bloody vomit, with pneumoperitoneum noted on CT examination. As the pneumoperitoneum was limited within the upper abdomen, especially around the liver and the duodenum, we diagnosed the child had anupper gastrointestinal tract perforation. Because the symptoms started less than 24 hours prior to admission, the amount of ascites was low, and the hemodynamic status and pain were under control, conservative treatment was performed initially. The treatment consisted of total parenteral nutrition with administration of antibiotics and the use of anti-ulcerogenic drugs. The patient’s body temperature recovered to within the normal range by the next day after treatment. An upper gastrointestinal endoscopy revealed a duodenal ulcer at the first portion of the duodenum on day 7, and oral feeding was then started on day 8 before the patient was discharged without any adverse events on day 12 after admission. Conservative treatment for duodenal perforations in pediatric patients has been rarely reported. In addition to our case report, we herein review 13 previously reported cases of conservatively treated perforated duodenal ulcers in pediatric patients with their clinical features.
