Gastroenterologia Japonica

, Volume 24, Issue 6, pp 707–710 | Cite as

Gastric acid secretion in a child with postbulbar duodenal ulcer

  • Seiichi Kato
  • Hoshiro Suzuki
  • Yoshinori Harada
  • Kazuhisa Komatsu
  • Mayumi Kobayashi
Case Report


A 14-year-old case was reported with a primary postbulbar duodenal ulcer, which was confirmed by barium meal study and duodenoscopy. In the preoperative study, the patient showed marked gastric hyperacidity: maximal and peak acid output were 0.980 and 1.434 mEq/kg/hr, respectively. As previously described, hyperacidity appears to be a main factor in the pathogenesis of postbulbar duodenal ulcer. Fasting and postprandial serum gastrin secretion was not thought to be responsible for gastric hyperacidity in the present case. Upon histological investigation, the operatively resected stomach did not suggest a possible relationship between hyperacidity and an enlarged parietal cell mass.

Key words

child gastric acid gastritis parietal cell postbulbar duodenal ulcer 


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  1. 1.
    Ramos AR, Kirsner JB, Palmer WL: Peptic ulcer in children. AMA J Dis Child 1960;99:135–148Google Scholar
  2. 2.
    Deckelbaum RJ, Roy CC, Lussier-Lazaroff J, et al: Peptic ulcer disease: a clinical study in 73 children. Can Med Assoc J 1974;111:225–228PubMedGoogle Scholar
  3. 3.
    Kawai K, Kohli Y, Fujisawa T: X-ray diagnosis of postbulbar duodenal ulcer by means of double air contrast method. Gastroenterol Jpn 1970;5:293–298Google Scholar
  4. 4.
    Christie DL, Ament ME: Gastric acid hypersecretion in children with duodenal ulcer. Gastroenterology 1976;71:242–244PubMedGoogle Scholar
  5. 5.
    Roth JLA, Stein GN, Morrissey JF, et al: Diagnosis of peptic ulcer. In: Berk JE, Haubrich WS, Kaiser MH, eds. Gastroenterology Vol. 2. WB Saunders, Philadelphia. 1985;1060–1115Google Scholar
  6. 6.
    Ritchie JD: Postbulbar duodenal ulcer. Aust NZ J Surg 1976;46:116–120Google Scholar
  7. 7.
    Portis SA, Jáffe RH: Study of peptic ulcer based on necropsy records. JAMA 1938;110:6–12Google Scholar
  8. 8.
    Hines JR, Geurkink RE: Postbulbar peptic ulceration of the duodenum. Surg Gynecol Obstet 1976;142:13–15PubMedGoogle Scholar
  9. 9.
    Sturtevant M, Shapiro LL: Gastric and duodenal ulcer. Arch Intern Med 1926;38:41–56Google Scholar
  10. 10.
    Nord K, Rossi T, Lebenthal E: Peptic ulcer in children Am J Gastroenterol 1981;75:153–157PubMedGoogle Scholar
  11. 11.
    Kishi S, Seki H, Kitamura Y, et al: Gastric secretory capacity in cases of post-bulbar ulcer of the duodenum. Tokushima J Exp Med 1979;26:13–18PubMedGoogle Scholar
  12. 12.
    Kaminishi M, Shimazu R, Kuramoto S, et al: A clinicopathological study of post-bulbar duodenal ulcer-analysis of 6 cases and comparison to usual chronic duodenal ulcer. Jpn J Surg 1987;17:140–145PubMedCrossRefGoogle Scholar
  13. 13.
    Tarn PKH: Hypergastrinemia in children with duodenal ulcer. J Pediatr Surg 1988;23:331–334CrossRefGoogle Scholar
  14. 14.
    Yamashiro Y, Nawate G: Gastrin secretion in normal infants and children. Part 2. Postprandial and interdigestive secretion patterns of serum gastrin. Acta Paediatr Jpn 1988;30:311–318PubMedGoogle Scholar
  15. 15.
    Schranger J, Spink R, Mitra S: The antrum in patients with duodenal and gastric ulcers. Gut 1967;8:497–508CrossRefGoogle Scholar
  16. 16.
    Nielsen HO, Munoz JD, Kronborg O, et al: The antrum in duodenal ulcer patients: relationship between antrum size, nerve of Latarjet, gastrin cell quantity, and gastric acid secretion. Scand J Gastroenterol 1981;16:491–495PubMedCrossRefGoogle Scholar
  17. 17.
    Ramsdell JA, Bartholomew LG, Cain JC, et al: Postbulbar duodenal ulcer. Ann Intern Med 1957;46:700–710Google Scholar
  18. 18.
    Cooke L, Hutton CF: Postbulbar duodenal ulceration. Lancet 1958;l:754–757CrossRefGoogle Scholar
  19. 19.
    Mullens JE, Bird GS: Peptic ulceration of the postbulbar portion of the duodenum. Can J Surg 1969,12:27–31PubMedGoogle Scholar
  20. 20.
    Pattison AC, Stellar A: Surgical management of postbulbar duodenal ulcers. Am J Surg 1966;111:313–318PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Castroenterology 1989

Authors and Affiliations

  • Seiichi Kato
    • 1
  • Hoshiro Suzuki
    • 1
  • Yoshinori Harada
    • 2
  • Kazuhisa Komatsu
    • 2
  • Mayumi Kobayashi
    • 1
  1. 1.Department of PediatricsSendai City HospitalSendaiJapan
  2. 2.Departments of Pediatric SurgeryIwaki Kyoritsu General HospitalIwakiJapan

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