Perforated peptic ulcer in an infant

We describe a case of perforated peptic ulcer (PPU) in a 9-month-old boy. A bdominal distension was the first clinical sign of PPU. Before he developed abdominal distension, the patient had suffered from an upper respiratory t ract infection with fever for about 2 weeks, which was treated intermittent ly with ibuprofen. A plain abdominal radiograph revealed pneumoperitoneum w ith a football sign. At laparotomy, a 0.8-cm perforated hole was found over the prepyloric area. Simple closure with omental patching was performed af ter debridement of the perforation. Pathologic examination showed chronic p eptic ulcer with Helicobacter pylori infection. The postoperative course an d outcome were satisfactory. The stress of underlying disease, use of ibupr ofen, blood type (A), and H, pylori infection might have contributed to the development of PPU in this patient. PPU in infancy is rare and has a high mortality rate; early recognition and prompt surgical intervention are key to successful management.