An 11-year-old girl vomited blood during school and was taken to our hospital. A duodenal ulcer was detected by upper gastrointestinal endoscopy and treated with ethanol injection therapy. She was negative for Helicobacter pylori infection by three tests: rapid urease test, circulating antibody, and antigen in stool specimens.
While H. pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) have been major causes of peptic ulcer, the percentage of idiopathic ulcers (e.g., non-H. pylori, non-NSAIDs ulcers) has increased. The recurrence rate of idiopathic ulcer is high, requiring preventive measures against its recurrence.
Although specific precautions are required, therapeutic endoscopy for pediatric patients is feasible in the endoscopy unit, provided that sufficient adjustments of settings can be undertaken in collaboration with relevant physicians including pediatric surgeons.
