Bulbar Stenosis Revealing Duodenal Ulcer Disease In A Child: About A Case

Abstract

Amal Belkhatir, Sidi Mohamed Addou, Habib Kies and Samir Azzouni

Duodenal ulcer disease is relatively rare in children. Can be discovered at the stage of bulbar stenosis which is a complication whose treatment is essentially surgical; it is particularly mentioned in the case of chronic vomiting. A young child of 11 years old was admitted to the hospital 08 years ago for chronic vomiting associated with weight loss. He had a personal history of failure to thrive at the age of 6 without obvious etiology, and occasional consumption of shisha. The normal clinical examination contrasted with a biological inflammatory syndrome. An esogastroduodenal endoscopy carried out showed a tight pyloro-bulbar stenosis that could not be overcome, the biopsies taken showed non-specific duodenitis and absence of signs of malignancy, justifying sequential treatment with additional exploration: abdominal-pelvic scan and an esogastroduodenal transit confirming the stenosis. fibrous. Surgical treatment was carried out by a Mikulicz pyloroplasty, with good postoperative outcomes. The child remained asymptomatic. At the age of 20, occurrence of another complication of his ulcer disease such as heavy digestive bleeding requiring hospitalization in the gastroenterology department. The evolution was favorable under massive transfusion and treatment including amoxicillin, clarithromycin and metronidazole (14 days) and omeprazole (7 weeks). An endoscopic check one month later showed complete healing of the ulcer.

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