Peptic ulcer disease (PUD) in children remains rare and diffi cult to diagnose before the onset of complications. We describe a 3-year-old child with perforated duodenal ulcer, associated with lower respiratory tract infection and hyperthyroidism. Upper GI endoscopy revealed three clean based ulcers in the fi rst part of duodenum, erect chest x-ray showed bilateral gas under diaphragm and CT scan confi rmed massive pneumoperitoneum. Emergency exploratory laparotomy detected perforation in the anterior wall of duodenum, managed with simple sutural closure. PUD in children is rare and high index of suspicion is required to prevent complications.
Duodenal ulcer, perforation, laparotomy, hyperthyroidism, H. pylori.
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