Four cases of duodenal ulceration in children simulating acute appendicitis.

The general impression in this country appears to be that duodenal ulceration is an extremely rare condition in childhood. Recent experiences do not entirely corroborate this opinion, as duodenal ulceration has been diagnosed in young children in no fewer than four cases during the past year at one Emergency Medical Service Sector Hospital. All these patients were sent into hospital as cases of acute appendicitis and this diagnosis appeared correct clinically. An accurate history was difficult to obtain in such young children; the presence of a temperature, a raised pulse, a furred tongue, pain and tenderness in the right iliac fossa made laparotomy imperative. The removal of normal appendices suggested that further investigations were desirable. Accordingly fractional test meals followed by barium meal examinations were carried out in each case, with results which will be discussed.