RT Book, Section A1 Smith, Mindy A. A1 Azhary, Hend A2 Usatine, Richard P. A2 Sabella, Camille A2 Smith, Mindy Ann A2 Mayeaux, E.J. A2 Chumley, Heidi S. A2 Appachi, Elumalai SR Print(0) ID 1114872091 T1 Peptic Ulcer Disease T2 The Color Atlas of Pediatrics YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 978-0-07-176701-9 LK accesspediatrics.mhmedical.com/content.aspx?aid=1114872091 RD 2024/03/28 AB A 10-year-old boy is brought in by his mother because of several episodes of vomiting. The most recent episode was small volume and had some brown-colored material in it. The boy tells you that he has had stomach pain off and on in the past few months and feels nauseated. He has not been having difficulty in school but his mother tells you that they will likely need to move soon as his father lost his job recently and has been unable to find work. The patient is the oldest of the 3 boys and shares a room with his brothers. He worries about his dad and hopes that he will be able to stay at his school. You discuss your concerns and recommend that the patient undergo esophagogastroduodenoscopy (EGD). His mother states that the children have health insurance through a state program and agrees to the testing. You start the patient on generic ranitidine. His EGD reveals a small pyloric ulcer and the biopsy specimens test positive for Helicobacter pylori (Figure 55-1). You prescribe 10 days of triple therapy with bismuth salts, amoxicillin, and metronidazole as the child's insurance does not cover the more expensive alternative medications.