Portal hypertension and duodenal ulcer in children.
OBJECTIVE
The prevalence of duodenal ulcer (DU) in adult patients with portal hypertension is higher than in patients without portal hypertension. This study investigates the prevalence and characteristics of DU in children with portal hypertension.


METHODS
From January 1997 to December 2001, 80 children with portal hypertension who had undergone upper intestinal endoscopic examinations were enrolled. Possible factors contributing to the development of DU including severity of liver disease, portal hypertension, H. pylori, and serum gastrin level were studied. The control group consisted of 80 age-and sex-matched children with gastrointestinal symptoms but no liver disease and who underwent endoscopic examination during the same period.


RESULTS
The prevalence of DU was significantly higher in children with portal hypertension than in children with digestive symptoms only (22.5%v 8.8%; P =0.017). DU was more common and appeared earlier in children with a history of variceal bleeding. The presence of DU was independent of the severity of liver disease, H. pylori infection and serum gastrin level.


CONCLUSIONS
DU occurs commonly in children with portal hypertension, especially in those who have had variceal bleeding. It is mandatory to screen a patient with gastrointestinal bleeding for DU even in the presence of esophageal varices. Elevated portal pressure might be a factor contributing to the development of DU.
Hung
Pei-Yin
PY
Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Ni
Yen-Hsuan
YH
Hsu
Hong-Yuan
HY
Chang
Mei-Hwei
MH
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004381:Duodenal Ulcer / Q000453:epidemiology* / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices; D005260:Female; D005755:Gastrins / Q000097:blood; D016481:Helicobacter Infections / Q000453:epidemiology / Q000209:etiology; D016480:Helicobacter pylori; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000453:epidemiology; D007223:Infant; D008297:Male; D015995:Prevalence
D005755:Gastrins