Alshehri A, Alsinan TA. Perforated duodenal ulcer secondary to deferasirox use in a child successfully managed with laparoscopic drainage: A case report . World J Clin Cases 2022; 10(34): 12775-12780 [PMID: 36579108 DOI: 10.12998/wjcc.v10.i34.12775]
Corresponding Author of This Article
Abdullah Alshehri, FRSC, MBBS, MSc, Assistant Professor, Department of Surgery, College of Medicine, King Saud University, Hassan Abdullah Alsheikh, Riyadh 12372, Saudi Arabia. abalshehri@ksu.edu.sa
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2022; 10(34): 12775-12780 Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12775
Perforated duodenal ulcer secondary to deferasirox use in a child successfully managed with laparoscopic drainage: A case report
Abdullah Alshehri, Tuqa Adil Alsinan
Abdullah Alshehri, Department of Surgery, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
Tuqa Adil Alsinan, Department of Pediatric Surgery, Prince Sultan Military Medical City, Riyadh 12211, Saudi Arabia
Tuqa Adil Alsinan, College of Medicine, Alfaisal University, Riyadh 12211, Saudi Arabia
Author contributions: Authors contributions: Alshehri A was the patient’s primary surgeon; Alshehri A and Alsinan TA collected the data and wrote and approved the manuscript.
Informed consent statement: Informed written consent was obtained from the guardians of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdullah Alshehri, FRSC, MBBS, MSc, Assistant Professor, Department of Surgery, College of Medicine, King Saud University, Hassan Abdullah Alsheikh, Riyadh 12372, Saudi Arabia. abalshehri@ksu.edu.sa
Received: September 27, 2022 Peer-review started: September 27, 2022 First decision: October 13, 2022 Revised: November 3, 2022 Accepted: November 8, 2022 Article in press: November 8, 2022 Published online: December 6, 2022 Processing time: 65 Days and 20 Hours
Abstract
BACKGROUND
A perforated gastroduodenal ulcer is rarely observed in children. Certain medications have been reported to cause ulcerations. Deferasirox, an iron chelating agent, has been previously reported to be associated with the development of gastroduodenal ulcers.
CASE SUMMARY
We report a case of a 3-year-old boy who was diagnosed with beta thalassemia major and treated with deferasirox. He presented to the emergency department with an acute abdomen. A perforated duodenal ulcer was suspected after X-ray imaging and laparoscopic exploration. It was successfully managed with laparoscopic washout and drainage.
CONCLUSION
Due to the rarity and severity of this case, it is a reminder that prevention and early recognition of gastrointestinal complications in patients receiving deferasirox are crucial. Minimally invasive laparoscopic surgery is both safe and feasible to treat perforated duodenal ulcers in selected patients.
Core Tip: Deferasirox, an iron chelating agent, is associated with gastroduodenal ulcers. However, reports of perforated gastroduodenal ulcers in pediatric patients are rare. The pediatric patient presented in this report was previously diagnosed with beta thalassemia major and was treated with deferasirox. He presented to the emergency department with an acute abdomen. We suspected a perforated duodenal ulcer after X-ray and laparoscopic exploration. The patient recovered well after laparoscopic washout and drainage. Early recognition of this life threatening complication in the pediatric population is essential. Minimally invasive laparoscopic surgery is a safe and feasible management option for perforated duodenal ulcers.
