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Abstract
Introduction: Peptic ulcer bleeding in children is rare. Symptoms vary widely among patients and are often nonspecific, making early diagnosis challenging. The disease is usually detected only when severe complications such as hemorrhage or perforation occur. This report presents a case of a 9-year-old girl admitted with lower gastrointestinal bleeding symptoms.
Case report: A 9-year-old girl was admitted to the hospital due to clotted and fresh blood in her stool. She had no prior history of gastrointestinal disease or NSAID use. Upon admission, she showed signs of hypovolemic shock and was treated with intravenous Ringer lactate and blood transfusion. After 2 hours, her hemodynamic condition stabilized. Initially, her hemoglobin level was 9.1 g/dl, but it dropped to 5.1 g/dl after 8 hours. Emergency GI endoscopy revealed an active bleeding site in the duodenum, which was treated with an 8 ml injection of Adrenaline 1/1000. The patient stabilized and was discharged after 2 weeks.
Results and discussion: Gastric ulcers are uncommon in children and are rarely considered a cause of abdominal pain. Consequently, pediatric patients are often diagnosed only when complications arise. Hemoglobin level remains the most reliable indicator for assessing bleeding severity. Flexible upper GI endoscopy and gastric biopsy are considered the gold standards for diagnosis. Endoscopic hemostasis has proven to be an effective and safe treatment for children.
Conclusion: Pediatric ulcer symptoms are highly variable and often nonspecific, making early diagnosis difficult. The complication rate is higher than in adults. Therefore, multidisciplinary collaboration is essential for timely diagnosis and treatment, improving patient outcomes.
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