Multimodal Diagnostic and Therapeutic Strategy for Duodenal Perforation Accompanied by Recurrent Gastrointestinal Hemorrhage in a 2-Year-Old Pediatric Patient: A Case Study and Systematic Literature Review

Multimodal Diagnostic and Therapeutic Strategy for Duodenal Perforation Accompanied by Recurrent Gastrointestinal Hemorrhage in a 2-Year-Old Pediatric Patient: A Case Study and Systematic Literature Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Multimodal Diagnostic and Therapeutic Strategy for Duodenal Perforation Accompanied by Recurrent Gastrointestinal Hemorrhage in a 2-Year-Old Pediatric Patient: A Case Study and Systematic Literature Review Rongkun Zhu, Yanan Zhang, Jingjing Liu, Di Wang, Xiaoxuan Ma, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9313057/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Objective To investigate the key clinical diagnostic and therapeutic points, challenges and corresponding strategies for duodenal perforation complicated with recurrent gastrointestinal bleeding in children, and to provide a clinical reference for managing this rare pediatric acute critical condition. Methods The clinical data of a 2-year-and-7-month-old female child with duodenal perforation and recurrent gastrointestinal bleeding were retrospectively analyzed. A systematic review and analysis were conducted from the perspectives of etiology, diagnosis, treatment and postoperative management, combined with relevant domestic and foreign literature over the past decade. Results A 2-year-and-7-month-old Chinese female child presented with viral enteritis initially, which progressed to duodenal perforation complicated with recurrent gastrointestinal bleeding. She received sequential interventions including duodenal perforation repair, gastroscopic exploration, gastrointestinal reconstruction, and transcatheter gastroduodenal artery embolization. The cumulative blood loss exceeded 2000 mL, with total transfusion of 800 mL whole blood, 46 units of packed red blood cells, 2870 mL fresh frozen plasma, and 19 units of cryoprecipitate. Through whole-course multidisciplinary team (MDT) collaboration and refined comprehensive supportive therapy, the child achieved complete recovery with no recurrent bleeding. Conclusion The diagnosis and treatment of duodenal perforation complicated with recurrent gastrointestinal bleeding in children should focus on the core features of pediatric physiological particularities, etiological complexity, age-stage specificity and targeted management of clinical challenges. Adopting multimodal localization approaches, rationally selecting therapeutic regimens and relying on whole-course MDT collaboration can effectively reduce the risk of rebleeding and improve the prognosis of affected children. Children Duodenal Perforation Recurrent Gastrointestinal Bleeding Gastroduodenal Artery Embolization MDT Collaboration Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 18 May, 2026 Reviews received at journal 18 Apr, 2026 Reviewers agreed at journal 14 Apr, 2026 Reviewers invited by journal 14 Apr, 2026 Editor invited by journal 09 Apr, 2026 Editor assigned by journal 07 Apr, 2026 Submission checks completed at journal 07 Apr, 2026 First submitted to journal 03 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9313057","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":625540231,"identity":"b652d05d-c970-4657-8537-5cfb0ad117c2","order_by":0,"name":"Rongkun Zhu","email":"","orcid":"","institution":"The Affiliated Hospital of Qingdao University","correspondingAuthor":false,"prefix":"","firstName":"Rongkun","middleName":"","lastName":"Zhu","suffix":""},{"id":625540232,"identity":"99513ec4-52d9-43b3-966f-c70f347f95e5","order_by":1,"name":"Yanan Zhang","email":"","orcid":"","institution":"The Affiliated Hospital of Qingdao 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Review","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Children, Duodenal Perforation, Recurrent Gastrointestinal Bleeding, Gastroduodenal Artery Embolization, MDT Collaboration","lastPublishedDoi":"10.21203/rs.3.rs-9313057/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9313057/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo investigate the key clinical diagnostic and therapeutic points, challenges and corresponding strategies for duodenal perforation complicated with recurrent gastrointestinal bleeding in children, and to provide a clinical reference for managing this rare pediatric acute critical condition.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe clinical data of a 2-year-and-7-month-old female child with duodenal perforation and recurrent gastrointestinal bleeding were retrospectively analyzed. A systematic review and analysis were conducted from the perspectives of etiology, diagnosis, treatment and postoperative management, combined with relevant domestic and foreign literature over the past decade.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA 2-year-and-7-month-old Chinese female child presented with viral enteritis initially, which progressed to duodenal perforation complicated with recurrent gastrointestinal bleeding. She received sequential interventions including duodenal perforation repair, gastroscopic exploration, gastrointestinal reconstruction, and transcatheter gastroduodenal artery embolization. The cumulative blood loss exceeded 2000 mL, with total transfusion of 800 mL whole blood, 46 units of packed red blood cells, 2870 mL fresh frozen plasma, and 19 units of cryoprecipitate. Through whole-course multidisciplinary team (MDT) collaboration and refined comprehensive supportive therapy, the child achieved complete recovery with no recurrent bleeding.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe diagnosis and treatment of duodenal perforation complicated with recurrent gastrointestinal bleeding in children should focus on the core features of pediatric physiological particularities, etiological complexity, age-stage specificity and targeted management of clinical challenges. Adopting multimodal localization approaches, rationally selecting therapeutic regimens and relying on whole-course MDT collaboration can effectively reduce the risk of rebleeding and improve the prognosis of affected children.\u003c/p\u003e","manuscriptTitle":"Multimodal Diagnostic and Therapeutic Strategy for Duodenal Perforation Accompanied by Recurrent Gastrointestinal Hemorrhage in a 2-Year-Old Pediatric Patient: A Case Study and Systematic Literature Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-21 08:19:27","doi":"10.21203/rs.3.rs-9313057/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"251786789267578196090024463535735766550","date":"2026-05-18T22:39:21+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-18T20:29:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"68003145329847500771434646016598265536","date":"2026-04-14T11:43:25+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-14T11:00:13+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-09T07:20:38+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-07T07:19:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-07T07:18:27+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pediatrics","date":"2026-04-03T12:39:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pediatrics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bped","sideBox":"Learn more about [BMC Pediatrics](http://bmcpediatr.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bped/default.aspx","title":"BMC Pediatrics","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b0efd5a3-b120-4f00-aef5-c70b3bc0cba9","owner":[],"postedDate":"April 21st, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"251786789267578196090024463535735766550","date":"2026-05-18T22:39:21+00:00","index":36,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-21T08:19:27+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-21 08:19:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9313057","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9313057","identity":"rs-9313057","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}