REVISTA ROMÂNÅ DE PEDIATRIE – VOLUMUL LXIII, NR. 3, AN 2014 254 Coresponding author: Ancuta Ignat, “Gr. T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, Iasi E-mail: anca_ign@yahoo.com CLINICAL-EPIDEMIOLOGICAL CONSIDERATIONS REGARDING PRIMARY PEPTIC ULCER IN CHILDREN – 5 YEARS RETROSPECTIVE STUDY Smaranda Diaconescu, Ancuta Ignat, Nicoleta Gimiga, Claudia Olaru, Gabriela Paduraru, Alexandru Lacatus, Sandu Gabriel Aprodu, Marin Burlea “Gr. T. Popa” University of Medicine and Pharmacy, Iasi ABSTRACT Primary peptic ulcer still remains highly quoted in children from developing countries, the infection with H. py- lori having a high incidence among this cases. Between 2007 and 2012 a retrospective study was performed, involving 84 children who were hospitalized in our clinic, ulcer disease being the main diagnosis.The study’s inclusion criteria were suggestive clinical symptoms and positive endoscopy. The studied group consisted by 79 children with primary ulcer and 5 with secondary ulcer. Reporting data for 1,400,000 children population in North – Eastern Romania an incidence of 5.64/100.000 of primitive ulcer disease has been found, the frequency being 2.58% compared with the overall 3052 upper digestive endoscopies done in the years mentioned above. Male to female ratio was 1.46:1. 77.41% of the patients originated in urban areas. The onset was by functional diges- tive syndrome in 70,89% of the cases or by complications in 29.11% of the cases. By upper digestive endos- copy 62 duodenal ulcers (DU) and 10 gastric ulcers (GU) were identified. Perforation allowed intraoperative diagnosis of ulcerative lesions in 7 children. 70.89% were H. pylori infection – related ulcers. The contributing factors for developing this condition were unproper diet (63.16%), smoking (57.89), alcohol consumption (15.78), psychological stress (27.27%). We obtained a significant correlation between the high number of a family members, (r = 0.63%; p = 0.002), the low socio-economical status (r = 0.87, p = 0.0003) and H.pylori infection. We used the standard triple therapy on 73.33% of the patients, the qvadruple therapy, based on bis- muth on 16.66% of the children, and the sequential therapy in 10% of the cases. The global eradication rate was 66.66% therefore we considered this as being an indirect proof for the high claritromycine resistance in children from our region. Keywords: primary ulcer disease, child, H.pylori CASE STUDIES INTRODUCTION Peptic ulcer represents a gastric or duodenal mucosa discontinuity, along with muscularis muco- sa penetration and submucosal exposure (1). In the last two centuries, the peptic ulcer was a major threat for the population, having a high morta- lity and morbidity. The epidemiological data for the peptic ulcer and its complications revealed major ge- ographical variation regarding the incidence and prevalence. (2). Discovering the antisecretory thera- py, along with Helicobacter pylori infection have been associated with a decrease of peptic ulcer’s rate; thus, the causes, the pathogenesis and the treat- ment of this disease have been reconsidered. Peptic ulcer is classified in primary and secon- dary ulcer, depending on the subjacent pathology. The ulcer disease still remains frequent in children from developing countries that have a high inciden- ce of H. pylori infection, with a high percentage of the people having a deficitary socio-economical status. The disease’s ethyology also involves an im- paired balance between defence and agression fac- tors, heredity, familial history and psychological factors. AIMS The aims of this study is to investigate the pre- valence, the clinical characteristics and risk factors regarding the ulcer disease in hospitalized children from the 5th Clinics of Pediatric Gastroenterology from „Sf. Maria“ Hospital, Iaşi, between 2007-2012.