Childhood Peptic Ulcer Perforation — Radiology and Electrocardiography in Clinical Nursing Practice with Public Health and Health Administration Implications

Abstract

Childhood peptic ulcer perforation (PUP) is a rare but life-threatening pediatric emergency characterized by atypical clinical presentation and high risk of complications. Early and accurate diagnosis is critical to improving survival and reducing morbidity. Radiology, including plain abdominal radiographs, ultrasound, and computed tomography, remains the cornerstone for identifying perforation and guiding surgical management. Electrocardiography (ECG), although less frequently emphasized, provides important insights into systemic complications such as electrolyte disturbances, arrhythmias, and perioperative instability, thereby complementing radiological findings.

Beyond the acute clinical setting, PUP has broader public health implications. Delayed diagnosis, limited access to advanced imaging, and lack of awareness among caregivers contribute to higher morbidity in low-resource settings. Preventive strategies, particularly addressing Helicobacter pylori infection, rational prescribing of non-steroidal anti-inflammatory drugs (NSAIDs), and caregiver education, are essential to reduce the incidence of pediatric ulcers and their complications. Recent updates in international guidelines highlight the shift toward bismuth-based quadruple therapy for H. pylori eradication, reflecting the growing importance of antibiotic stewardship and regional resistance monitoring.

This article integrates radiological and electrocardiographic approaches with public health perspectives, emphasizing the value of a holistic, multidisciplinary framework. By aligning acute diagnostic tools with preventive health strategies, clinicians and policymakers can improve both individual patient outcomes and broader child health equity.