Articles Vol. 67 No. CĐ5-NCKH 04/05/2026

CLINICAL FEATURES AND TREATMENT RESULTS OF PEDIATRIC PEPTIC ULCER DISEASE WITH GASTROINTESTINAL HEMORRHAGE AT THE PEDIATRICS CENTER, BACH MAI HOSPITAL

Trang Nguyen Thi1, Nam Nguyen Thanh2, Thoi Vu Huu2, Anh Trieu Thi Van3, Anh Tran Thi Van3, Thanh Ta Quang4, Viet Lam Thai5, Dem Pham Van1
1 Gia Lam General Hospital, Hanoi, Vietnam.
2 Bach Mai Hospital
3 University of Medicine and Pharmacy, Vietnam National University, Hanoi
4 Bac Thang Long Hospital
5 Dai Nam University,
DOI: 10.52163/yhc.v67iCD5.4962
176 Views
86 Downloads
Abstract

Study aims: Description Clinical Features and Treatment Results of Pediatric Peptic Ulcer Disease with Gastrointestinal Hemorrhage at the Pediatrics Center, Bach Mai Hospital. Methods:A descriptive cross-sectional study in 58 children under 16 years of age diagnosed with gastrointestinal bleeding secondary to peptic ulcer disease at the Pediatric Center, Bach Mai Hospital, from October 1, 2024, to September 30, 2025.

Results: The study enrolled 58 cases, with males comprising 81% (male-to-female ratio: 4.27:1). The highest prevalence was observed in the age group >10 years (93.1%). The most common clinical manifestations were gastrointestinal symptoms, overt bleeding, and anemia, respectively: epigastric pain (63.8%), melena (55.2%), and pallor of skin and mucous membranes (79.3%). The most frequent bleeding site was the duodenal bulb (79.3%). According to the Forrest classification, Forrest IIc lesions predominated (39.7%). Blood transfusion was administered to 30 patients, 15 patients, with early endoscopy (<24 hours) performed in 70.7% of cases. Helicobacter pylori infection was identified in 44.8% of patients, all of whom received regimen-based eradication therapy. The majority of patients exhibited symptom resolution with treatment duration <10 days.

Conclusion: Peptic ulcer disease complicated by gastrointestinal bleeding predominantly affects male children, with the highest incidence in those >10 years of age. The primary reasons for hospital admission were abdominal pain (46.6%) and melena (55.2%). The leading etiology of gastrointestinal bleeding was duodenal bulb ulceration (79.3%). Early detection, prompt diagnosis, and timely intervention mitigate complications associated with gastrointestinal bleeding due to peptic ulcer disease.

Keywords
peptic ulcer disease, upper gastrointestinal bleeding, Helicobacter pylori, esophagogastroduodenoscopy, treatment outcomes.
References
[1]
F. K. L. C. Angel Lanas, "Peptic ulcer disease," Lancet, vol. 390, no. 10094, pp. p. 613-624, 2017. Google Scholar
[2]
M. G. Graziella Guariso, "Update on Peptic Ulcers in the Pediatric Age," Ulcers, pp. p. 1-9, 2012. Google Scholar
[3]
F. Galos, M. I. Ionescu, M. D. L. Mirea, A. A. Boboc, A. Ioan, and C. Boboc, "Trends in Upper Gastrointestinal Bleeding in Children: The Impact of Helicobacter pylori Infection and Non-Steroidal Anti-Inflammatory Drug Use," (in eng), Antibiotics (Basel), vol. 13, no. 8, Aug 10 2024, doi: 10.3390/antibiotics13080752. Google Scholar
[4]
Z. Eusebi, "Epidemiology of H. pylori infection," Helicobacter, vol. 19, no. 1, pp. p. 1-5, 2014. Google Scholar
[5]
D. M. T. Vu Van Khien, Tran Manh Hai, et al, "Management of Antibiotic - Resistant H. pylori Infection: Perspectives from Vietnam," Gut and Liver, vol. 13, no. 5, pp. p. 483-497, 2019. Google Scholar
[6]
Hoang Thai Che "High Prevalence of Helicobacter pylori Infection Among School-Aged Children in Ho Chi Minh City, VietNam," (in eng), Int J Public Health, vol. 67, p. 1605354, 2022, doi: 10.3389/ijph.2022.1605354. Google Scholar
[7]
R. Borka Balas, L. E. Meliț, and C. O. Mărginean, "Worldwide Prevalence and Risk Factors of Helicobacter pylori Infection in Children," (in eng), Children (Basel), vol. 9, no. 9, Sep 6 2022, doi: 10.3390/children9091359. Google Scholar
[8]
Phạm Võ Phương Thảo “Nghiên cứu đặc điểm lâm sàng và hình ảnh nội soi ở trẻ viêm loét dạ dày tá tràng tại Trung tâm Nhi khoa, Bệnh viện Trung ương Huế”. Tạp Chí Y Dược học Cần Thơ, số p.h 78, Tháng Tám 2024, tr 188-94, doi:10.58490/ctump.2024i78.3117. Google Scholar
[9]
Gaevskaya, Y., B. R. Mathotaarachchi, and D. R. Yahathugoda. “Retrospective Case Study of Risk Factors, Clinical Features and Laboratory Parameters of Peptic Ulcer Disease in Pediatric Patients”. International Journal of Contemporary Pediatrics, vol. 12, no. 6, May 2025, pp. 884-9, doi:10.18203/2349-3291.ijcp20251464. Google Scholar
[10]
Shahrebabak, Maryam, Gholami et al. “Descriptive analysis of common causes of upper gastrointestinal bleeding in pediatric patients in Kerman: a study from 2022 to 2023.” BMC gastroenterology vol. 25,1 152. 10 Mar. 2025, doi:10.1186/s12876-025-03750-0 Google Scholar