Sudden syncope, accompanied by blood in the stool, hematemesis, and even a critical situation of hemorrhagic shock... At the end of November, the Pediatric Endoscopy Center of Sichuan Provincial People's Hospital received an 11-year-old boy in critical condition. After a series of symptomatic treatments to alleviate the condition in time, doctors found that the boy had Helicobacter pylori infection.
In China, the infection rate of Helicobacter pylori is as high as 40-60%, which means that about 560 million people are infected with Helicobacter pylori. At the end of November, a study published in the journal The Lancet pointed out that about half of the world's confirmed stomach cancers in China accounted for about half of the world's population, of which about 340,000 new stomach cancers were related to Helicobacter pylori infection.
Doctors remind that children with Helicobacter pylori infection has a certain spontaneous clearance rate, and the rate of re-infection after eradication may be higher than that of adults, so routine testing and treatment of Helicobacter pylori in children under 14 years of age is not recommended. ”
Referral of the child
The 11-year-old boy fainted and was admitted to the hospital
Post-hematemetic shock was critical for a time
On the morning of November 30 this year, 11-year-old boy Xiaoming (pseudonym) fainted at home, pale and confused, and was immediately taken to a nearby hospital by his family. The receiving doctor considered acute gastroenteritis and gave Xiaoming infusion therapy.
That night, Xiaoming, who was infusing, began to vomit a large amount of blood, and fainted again, accompanied by hemorrhagic shock, so he was urgently sent to the pediatric intensive care unit for rescue. According to Xiaoming's mother, at that time, Xiaoming's diastolic pressure was only 37 mmHg, and blood tests showed that hemoglobin was only 5 grams (the normal level was about 11 grams).
After hemorrhagic shock, Xiaoming's condition was very critical, and his condition developed rapidly, and after going to a number of hospitals, he finally came to the Pediatric Digestive Endoscopy Center of Sichuan Provincial People's Hospital and visited through the 24-hour green channel for gastrointestinal bleeding.
After being admitted to the hospital, the doctor learned that Xiaoming had a stomach discomfort a week ago, and the situation of dissolving black and slimy stools was not paid attention to by the parents.
Jiang Wenjun, director of the gastrointestinal endoscopy team of pediatric surgery of the provincial hospital, and Liu Yinghua, the attending physician, urgently discussed the treatment plan and decided to give active anti-shock and continuous blood transfusion life support, and at the same time, the emergency department performed gastroscopy to determine the cause of bleeding.
Dr. Liu Yinghua recalled that according to the typical symptoms of the child, it is highly suspected that it is caused by upper gastrointestinal bleeding, and the possibility of ulcers is high. Sure enough, through gastroscopy, it was found that the child's duodenal bulb had a huge ulcer. At the same time, the doctor also found that the endoscopic mucosa was swollen, chicken skin-like changes, and there was scattered punctate congestion, "We thought he probably had Helicobacter pylori infection." Liu Yinghua said that in view of the seriousness of the child's condition, he did not do a biopsy, but used a carbon 14 breath test to check and confirm that the child was infected with Helicobacter pylori.
Helicobacter pylori infection has been confirmed
Has a family history of infection and loves to drink cola and eat fried foods
Xiaoming's mother said that the family had a history of Helicobacter pylori disease, but had never examined Xiaoming. Xiaoming usually likes to drink Coke and eat fried and puffed foods. "This type of food is strongly irritating to the gastrointestinal tract and may also be a factor in its onset of heavy bleeding." Liu Yinghua said.
Liu Xiaogang, chief physician of the Digestive Endoscopy Center, said that children's peptic ulcer is one of the more common children's gastrointestinal diseases, most of the Helicobacter pylori infection has no obvious symptoms, only about 30% of the infected people will have indigestion, bloating, stomach ulcers and other symptoms. In children, more than 60% of peptic ulcers and bleeding are related to Helicobacter pylori infection, and about 80% occur in the duodenal area.
Because children's upper gastrointestinal bleeding is a high-risk disease that is easy to cause major bleeding, hemorrhagic shock, and even death, and requires emergency treatment, doctors remind parents to pay more attention to abnormal conditions such as blood vomiting and black stool in children, and take timely interventions.
Eventually, after a series of symptomatic treatments, Xiaoming's indicators gradually improved, the digestive tract did not bleed again, the hemoglobin rose to 10 grams, reaching the discharge criteria, and under the guidance of the doctor, oral anti-Helicobacter pylori drugs began.
On the morning of Tuesday, December 7, Xiaoming was discharged from the hospital and went home.
Before discharge, children, parents and medical staff take a group photo
At the end of November, The Lancet published a study showing that about half of the world's confirmed stomach cancers were diagnosed in China, of which about 340,000 new stomach cancers were associated with Helicobacter pylori infection.
In China, the infection rate of Helicobacter pylori is as high as 40-60%, which means that about 560 million people are infected with Helicobacter pylori.
Helicobacter pylori infection generally has no specific symptoms, the symptoms that will occur are mainly caused by helicobacter pylori infection-related diseases, such as chronic gastritis can cause belching, epigastric fullness, abdominal pain and other symptoms of dyspepsia; peptic ulcer generally appears at night abdominal pain, postprandial abdominal pain and other symptoms; when stomach cancer occurs, in addition to the above symptoms, there are often symptoms such as loss of appetite and weight loss. Therefore, after the infection is found, it is necessary to carry out treatment and eradication in time, and pay attention to re-examination to prevent re-infection.
However, for children infected with Helicobacter pylori, according to the latest expert consensus, compared with adults, children infected with Helicobacter pylori have a low risk of serious diseases, including peptic ulcer, atrophic gastritis and stomach cancer, and there are more unfavorable factors for treatment. And children with Helicobacter pylori infection has a certain spontaneous clearance rate, and the rate of reinfection after eradication may be higher than that of adults, so routine testing for Helicobacter pylori in children under 14 years of age is not recommended, "If symptoms occur, corresponding treatment should be carried out." Liu Yinghua said.
Red Star News reporter Yu Zunsu according to the interviewee
Edited by Yu Manga
(Download Red Star News, there are prizes for the newspaper!) ）
![After defecation, you may wish to see if there is blood in the stool, so that the analysis is hemorrhoids or rectal cancer signals![fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)