Successful Treatment by Laparoscopic Surgery of a 2-year Old Boy With Perforated Duodenal Ulcer

Abstract

A 2-years old boy was brought to our hospital because of fever, bloody vomit, and poor appetite. Plain chest X-ray and abdominal CT images showed intraabdominal free air; therefore, he was diagnosed as having upper gastrointestinal perforation. We performed an emergency operation by a laparoscopic procedure, and perforation (4.0 mm in diameter) of the duodenum was confirmed on the anterior duodenal bulb. We performed laparoscopic omental implantation and thoroughly irrigated the abdominal cavity. The postoperative course of the patient under treatment with antibiotics and a proton pump inhibitor was uneventful. He was discharged on the 5th postoperative day. We diagnosed him as having perforated duodenal ulcer. We were able to perform laparoscopic surgery as in adults without postoperative complications. We consider that laparoscopic surgery is useful for both diagnosis and treatment of infants with perforated gastric ulcer. We report a successful treatment of a rare pediatric case with perforated duodenal ulcer using laparoscopic surgery.