Statistical analysis of symptoms and signs in pediatric patients with peptic ulcer.

It is not well known which symptoms or signs related to peptic ulcer are crucial for its diagnosis in children. In order to clarify this problem, we evaluated the sensitivity, specificity, and positive and negative predictability of 13 ulcer-related symptoms and signs. The data of 160 patients, who were suspected of having peptic ulcer and had undergone endoscopic examinations, were studied. It was significant that five symptoms, i.e., presence of pain in the epigastrium, relationship between the time of pain and that of eating, family history, vomiting, and bleeding, were frequently found in ulcer patients. There was, however, no symptom or sign that predicted by itself precisely the existence of a peptic ulcer. Thus, we computed a discriminant function by combining the data by multivariate analysis. With this score, we could predict the existence of ulcer more precisely. Finally, it was concluded that epigastric pain, food-related pain, vomiting, bleeding, and family history were crucial factors for the diagnosis of peptic ulcer in childhood and that an overall consideration of symptoms and signs was needed for the evaluation of these factors.