Fatal Curling's Ulcer after Burns in a Child-a Case Report
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Burns are the most frequently recognized severe form of trauma occurring in childhood. The association of acute gastrointestinal tract disease with burn injury is known since first half of the 19th century. Curling's ulcer is a recognized complication of burn shock which occurs in the gastrointestinal tract in burned patient. It manifest during the second week, when infection and toxic absorption from the separating sloughs is predominant. It will be diagnosed only in the event of haemorrhage, perforation, or at necropsy, and presumably these do not occur in every case. Prognosis in Curling's ulcer is always serious, especially in children, death occurring most often from haemorrhage or perforation.
A rare case of acute duodenal ulcer in a nine-month-old infant after deep burns of both lower extremities is described. It gives the impression that it is necessary to take into consideration the possibility of Curling's ulcer in every case of deep and extensive burns in children.
Keywords
- Haubrich, Schaffner, Berk: Bockus Gastroenterology, W. B. Saunders company, 5th edition, 1995, vol 1, 660, 684 – 688.
- Ian FK, Muir, Peter F Jones. Curling’s ulcer: A rare condition. Br. J. Surg 1976: 63: 60 – 66.
- Fadaak HA. Gastrointestinal haemorrhage in burn patients the experience of a burns unit in Soudi Arabia. Annals of Burns and Fire Disasters. June 2000; 13(2): 81.
- Swan, J.: Case of Severe Burn. Edinburgh Med. J., 19:344, 1823.
- Curling, T. B.: On Acute Ulceration of the Duodenum, in Cases of Burns. Medico-Chir. Trans. Lond., 25:260, 1852.
- Pruitt B A, Foley FD, Moncrief JA. Curling’s Ulcer: A Clinical-Pathology Study of 323 Cases. Annals of Surgery October 1970, vol. 172(4); 523 – 536.
- Sevitt Simon, Duodenal and Gastric ulceration after burning. Brit. J. Surg. 1967: 54(1): 32 – 41.
- Pruitt BA. The burn patient: II later care and complications of thermal injury. Curr Probl Surg 1979;16:69–70.
- Czaja A.J., McAlhany J.C., Andes W.A. et al.: Acute gastric disease after cutaneous thermal injury. Arch. Surg., 110: 600-5, 1975.
- Czaja A.J., McAlhany J.C., Pruitt B.A.: Acute duodenitis and duodenal ulceration after burns. JAMA, 232: 621-6, 1975.
- Pingleton S.K., Hadzima S.K.: Enteral alimentation and gastroduodenal bleeding in mechanically ventilated patients. Crit. Care Med., 11: 13-18, 1983.
- Moscona. R., Kaufman T., Jacobs R., Hirshowitz B.: Prevention of gastrointestinal bleeding in burns. The effects of cimefidine or antacids combined with early enteral feeding. Burns, 12: 65-7, 1985.
- Choctaw W.T., Fujita C., Zawacki B.E.: Prevention of upper gastrointestinal bleeding in burn patients: A role for “elemental” diet. Arch. Surg., 115: 1073- 6, 1980.
- Solem L.D., Strate R.G., Fischer R.P.: Antacid therapy and nutritional supplementation in the prevention of Curling’s ulcer. Surg. Gynecol. Obstet., 148: 367-70, 1979.
- Raff T., Germann G., Hartmann B.: The value of early enteral nutrition in the prophylaxis of stress ulceration in the severely burned patient. Burns, 23: 313-8, 1997.
- Yang C.H., Hsu W., Shin T. (eds.): “Treatment of burns”. SpringerVerlag, Berlin, 1982.
- Blundell A. Non-fatal case of Curling’s ulcer in a child. British Medical Journal. July 17, 1954:133 – 134.
- Pruitt BA, Goodwin CW. Stress ulcer disease in the burned patient. World Journal of Surgery. 1981;5(2): 209-220,
- Agarwal SS, Kumar Lavlesh, Chavali KH, Jhaveri SH. Fatal Gastro-Intestinal Bleeding – A Complication Following Spinal Injury. JIAFM, 2005; 27(3): 192 – 194.
- Kirksey TD, Moncrief JA, Pruitt BA Jr, O’Neill JA Jr. Gastrointestinal Complications in Burns. Amer J Surg. 116:627, 1968.
- Goldman H, Rosoff CB, Pathogenesis of Acute Gastric Stress Ulcers. J. Path., 52:227, 1968.
- Fadaak H.A. Gastrointestinal haemorrhage in burn patients the experience of a burns unit in Saudi Arabia. Annals of Burns and Fire Disastersvol. XIII - n. 2 - June 2000.
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