PMID: 518170Dec 1, 1979Paper

Perforated stress ulcer in infants: a silent threat

Annals of Surgery
S D AdeyemiJ S Simpson

Abstract

Stress ulcer has become an important clinical entity and its two major complications--bleeding and perforation--are among the most baffling problems, in terms of management, in clinical practice. Perforation, though the less common of the two, is perhaps the most formidable particularly when this occurs in a very sick infant. Four such infants (cyanotic heart disease, gastroenteritis and two severe pneumonias) all developed this severe complication of their illness and after surgery two survived. Two of these infants presented with bleeding prior to perforation of their stress ulcer. The perforation diagnosis was initially not apparent and was first made after radiological examination. Clinical signs of peritonitis were absent as these infants were too sick for such signs to be elicited. All four ulcers were situated in the posterior wall of the duodenum. Two of these infants developed cardiac complications on the operating table, the cause of which was not very clear. It may have been due to the debilitation of these babies with the additional effect of anesthesia perhaps leading to myocardial toxicity. It is therefore recommended that: all sick infants on steroid therapy be placed on prophylactic antacids; abdominal girth mea...Continue Reading

References

Feb 26, 1976·The New England Journal of Medicine·H O Conn, B L Blitzer
Jun 1, 1967·Annals of Surgery·F Glenn, W R Grafe
Jan 1, 1968·The American Journal of Digestive Diseases·A T SmithH Oberhelman
Mar 1, 1967·The American Journal of Digestive Diseases·A R Cooke
Aug 11, 1960·The New England Journal of Medicine·H M SPIRO, S S MILLES

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Citations

Jun 21, 2001·ANZ Journal of Surgery·S BolisettyJ Whitehall
Feb 4, 1998·Baillière's Clinical Gastroenterology·M Thomson
Jan 16, 1999·Baillière's Clinical Gastroenterology·M Thomson, J Walker-Smith
Dec 1, 1981·Journal of Pediatric Surgery·M J BellR J Bower
Mar 30, 2005·Journal of Pediatric Gastroenterology and Nutrition·Christophe DupontPierre-Henri Benhamou
Mar 1, 1985·Drug Intelligence & Clinical Pharmacy·C W LloydB D Taylor

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