Clinical experience in the treatment of ulcer-induced gastric outlet obstruction in seven children

Peptic ulcer disease complicated with gastric outlet obstruction is rare in children. The experience in the treatment in children is limited. From 1987 to 1998, 7 children with gastric outlet obstruction due to peptic ulcer disease were encountered in our hospital. The 5 patients treated from October 1987 to May 1997 underwent truncal vagotomy, combined with pyloroplasty in 4 patients and antrectomy in 1. The indications for operation were failure of treatment with a histamine 2 (H2)-receptor antagonist. The remaining 2 patients, treated from June 1997 to October 1998, were successfully treated with oral omeprazole with or without the addition of antibiotics. These 2 patients had shorter hospital stays and could tolerate feeding earlier than those treated with truncal vagotomy. Although surgical treatment has merits in the management of children with peptic ulcer disease complicated with gastric outlet obstruction, in light of our cases we disclosed the trend toward intensive medical treatment.