Stress Duodenal Ulcer Presenting as Hematochezia in a Neonate

Rimjhim Shrivastava, Mukesh Rathore, Ravinder Goyal, BR Thapa
5.250 895


Primary duodenal ulcers are very rare in children under 10 years of age but stress induced ulceration in the stomach occurs more often in the neonatal period due to birth asphyxia, prolonged labour, caesarean deliveries, instrumentations, respiratory distress syndrome and sepsis. These present as acute onset of gastrointestinal bleed commonly as altered gastric aspirate, hematemesis or melena.
Management of a neonate with stress ulcer presenting as hematochezia
Upper Gastrointestinal Endoscopy (UGIE) done which revealed a large ,clean based ulcer in the antero-superior wall of the first part of the duodenum. Child was treated with lansoprazole.
The use of lansoprazole resulted in the complete healing of the ulcer after 7 days of the therapy.
Stress peptic ulcers should be suspected in a neonate presenting with massive gastrointestinal bleeding after difficult delivery and birth asphyxia. UGIE is mandatory to rule out lesions bleeding from stomach or duodenum or both.


Hematochezia; neonate; upper gastrointestinal endoscopy; duodenal ulcer; lansoprazole

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