Stress ulcers in childhood

The authors discuss 10 cases of stress ulcus with surgery in patients under 7 yr of age. Of these, 6 had burns and 4 had severe neurological processes. In all of them the ulcus was duodenally located. In one case there was a double ulcus, and a perforation in another. They point out the high frequency of ulcus on the rear side of the duodenal and next to the pylorus. The authors divide the patients with digestive hemorrhages into 2 large groups. In the first they include cases of intense shock and uncontrollable hemorrhaging, and recommend surgery as the only way to save these patients. In the second the hemorrhage is controllable and shock is not extreme, if surgery is done the cause of the hemorrhaging is not found, therefore, they prefer medical treatment. All possible diagnostic means should be used, and the authors also emphasize the importance of preventive measures. They recommend semi laparotomies even in cases of abdominal burns. Mortality was 20%, which they find quite acceptable, given the critical nature of the state of these patients when surgery was performed. They indicate that team work is indispensable, and emphasize the need for an Intensive Care Ward during the post operative period.