EARLY PROGNOSTIC SIGNS OF DUODENAL ULCER COMPLICATIONS IN CHILDREN

Abstract

Relevance. Duodenal ulcer bleeding is one of the most severe complications and ranks among the leading causes of mortality associated with duodenal ulcers. Purpose of the study. This study aimed to identify key predictors of a complicated duodenal ulcer course in pediatric patients. Materials and methods. The research included 42 children diagnosed with recurrent duodenal ulcers who received treatment at the 2nd SamMU clinic between 2021 and 2024. The primary group comprised 12 patients (28.6%) with complicated cases involving bleeding, while the comparison group included 30 patients (71.4%) with an uncomplicated course. The study analyzed anamnesis, clinical characteristics, and pH levels in affected children. Several prognostic factors for complicated duodenal ulcers were identified, including gender, age, genetic predisposition, erosive gastroduodenitis, multiple ulcerations, high bacterial colonization, and low pH levels in the antroduodenal region. Results and discussion. Analysis of medical history showed that 75% of children in the primary group had a family history of duodenal ulcer, with 33.3% of relatives experiencing complicated forms of the disease. In the comparison group, hereditary factors were present in 46.7% of cases, though none of their relatives had complications. Helicobacter pylori infection was detected in all patients from the complicated ulcer group (100%), while 80% of the control group tested positive. Additionally, elevated IgG titers against HP were significantly more common in the complicated ulcer group. Conclusions. Key prognostic markers for complicated duodenal ulcers in children include male gender, older school-age status, hereditary factors, extensive ulcerated areas, and multiple ulcerations. Early diagnosis and proactive medical supervision can help minimize the risk of severe complications in these patients.