The aim of the study was to investigate retrospectively a cohort of childre
n with peptic ulcer disease during a period that covers the recent changes
in diagnosis and management of the disease. Over a period of 9 years, 2550
children underwent upper gastrointestinal endoscopy for various reasons. Al
l children, in whom a diagnosis of primary peptic ulcer was established, we
re included in the study. Previous and current medical history, family hist
ory, endoscopic and histological outcome were evaluated and the children we
re regularly followed-up on an out-patient basis. Primary peptic ulcer was
diagnosed in 52 (10 gastric and 42 duodenal, 2%) out of 2550 children. The
median age of children with gastric ulcer was 6.5 years, whereas of those w
ith duodenal ulcer was 10.5 years (P = 0.04). With regard to clinical sympt
oms no significant difference was found between children with and without u
lcer. The prevalence of Helicobacter pylori infection was significantly hig
her in children with duodenal ulcer (62%) compared to those with gastric ul
cer (20%; P < 0.001). At first follow-up visit, I month after the end of tr
eatment, 19 symptomatic children underwent a repeat endoscopy, which showed
ulcer healing in 95% and failure in H. pylori eradication in 27%. During t
he long-term follow-up (median 3.5 years), six children became symptomatic.
Two of them had duodenal ulcer associated with positive H. pylori.
Conclusion Peptic ulcer disease is an uncommon disorder in childhood with n
on specific clinical features; it seems that efficient treatment and succes
sful Helicobacter pylori eradication result in clinical improvement and cur
e as well as in long-term healing of ulcers.