Peptic ulcer in children.

From January 1983 to April 1989, 39 children were diagnosed as suffering from primary peptic ulcer. Of these ulcers, 30 were duodenal, seven prepyloric, and two patients had a combination of both. Among 36 patients with H2-blocker therapy, 33 had treatment completed with ulcer healing assessed by endoscopic examinations. Sixteen patients (49%) had ulcer healing within a single 6-week course of treatment, whereas 17 patients (51%) required multiple 6-week courses. The latter group had a mean basal acid output (BAO) of 0.13 +/- 0.06 mmol/kg/h and a mean maximal acid output (MAO) of 0.48 +/- 0.12 mmol/kg/h, which is significantly higher (P less than .05 and P less than .005, respectively) than the mean BAO (0.08 +/- 0.06 mmol/kg/h) and mean MAO (0.31 +/- 0.11 mmol/kg/h) in patients whose ulcers healed within 6 weeks of treatment. Subsequent follow-up with endoscopy over a mean period of 1.8 years (range, 3 months to 6 years) showed 10 patients with recurrent ulcers. Life-table analysis showed a recurrence rate of 35% within 1 year after ulcer healing. Five patients required surgery for ulcer complications--obstruction (2), perforation (2), and bleeding (1). In two of these patients initial H2-blocker therapy was unsuccessful.