title: Perforated peptic ulcer disease in children: association of corticosteroid therapy.
abstract: Four children were treated at the Oregon Health Sciences University for perforated peptic ulcer disease over the last 15 years. All children were being treated for other severe underlying diseases at the time of perforation. All of the children were receiving corticosteroids; one was receiving ulcer prophylaxis. Presenting symptoms were those of a perforated viscus, and pneumoperitoneum was present in all patients. Simple closure and omental patching of the ulcer resulted in no operative mortality or morbidity. None of the ulcers have recurred. In reviewing the literature, corticosteroids were associated with perforated peptic ulcer disease in 17.8% of children with perforated peptic ulcer. Despite controversy regarding the role of corticosteroids in the causation of peptic ulcer, we recommend prophylaxis for all children receiving corticosteroids.
authors.affiliation: Department of Surgery, School of Medicine, Oregon Health Sciences University, Portland 97201.
authors.forename: S W
authors.initials: SW
authors.lastname: Bickler
authors.forename: M W
authors.initials: MW
authors.lastname: Harrison
authors.forename: J R
authors.initials: JR
authors.lastname: Campbell
mesh_terms: D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000009:adverse effects; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000150:complications; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D010439:Peptic Ulcer Perforation / Q000139:chemically induced* / Q000209:etiology; D011239:Prednisolone / Q000009:adverse effects; D011241:Prednisone / Q000009:adverse effects; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000150:complications
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D011239:Prednisolone; D011241:Prednisone