Pediatr Gastroenterol Hepatol Nutr.  2019 Jan;22(1):57-62. 10.5223/pghn.2019.22.1.57.

Usefulness of Ultrasonography in the Diagnosis of Peptic Ulcer Disease in Children

• Lee EJ
• Lee YJ
• Park JH

• KMID: 2430916
• DOI: http://doi.org/10.5223/pghn.2019.22.1.57

Abstract

PURPOSE
This study was performed to assess the clinical usefulness of transabdominal ultrasonography (TUS) in detecting peptic ulcer disease (PUD) in children.
METHODS
Twenty-four patients (19 boys, 5 girls; mean age, 10.6±4.5 years [range, 3.0-17.9 years]) who were admitted to the hospital for acute abdomen or gastrointestinal bleeding and diagnosed with PUD by endoscopy and who underwent TUS were included. Clinical data were retrospectively collected by reviewing patient medical records. Gastric ulcer (GU) was suspected when the gastric wall exceeded 8 mm in thickness and had lost its five-layer structure on TUS. Duodenal ulcer (DU) was suspected if the duodenal wall thickness exceeded 5 mm.
RESULTS
Sensitivity of TUS in diagnosing PUD was 66.7% for GU and 38.9% for DU. Mean age and body weight of the 11 patients suspected with PUD on TUS were 10.9±4.4 years and 38.1±17.2 kg, respectively. For 13 patients without suspected PUD, they were 12.1±4.1 years and 39.6±17.0 kg, respectively. There was a significant difference in height, weight, and body mass index between patients who were suspected to have PUD and those who were not suspected on TUS (p=0.014, 0.008, and 0.005, respectively). A significant difference in the sensitivity of TUS in diagnosing PUD was found between patients under 30 kg and those over 30 kg (88.9% and 20.0%, respectively; p=0.003).
CONCLUSION
TUS investigation of the stomach and duodenum is an efficient method for PUD detection in children with low body weight. TUS can be used in preliminary diagnostic work-up before further invasive tests.

Keyword

Ultrasonography; Stomach ulcer; Duodenal ulcer; Child

MeSH Terms

Abdomen, Acute
Body Mass Index
Body Weight
Child*
Diagnosis*
Duodenal Ulcer
Duodenum
Endoscopy
Female
Hemorrhage
Humans
Medical Records
Methods
Peptic Ulcer*
Retrospective Studies
Stomach
Stomach Ulcer
Ultrasonography*

Figure

• 

  Fig. 1 Transverse gray scale sonogram through the gastric antrum demonstrating marked, circumferential gastric wall thickening with loss of the gastric five-layer structure (arrow).

• 

  Fig. 2 Transverse gray scale sonogram through the duodenal bulb demonstrating hyperechoic center surrounded by a hypoechoic halo with various thicknesses (arrow).

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