Pediatric peptic ulcer disease (PUD) leading to massive upper gastrointestinal bleeding (UGIB) is a rare but life-threatening condition requiring rapid diagnosis and intervention. We present the case of a 16-year-old female who experienced severe hematemesis, melena, and hemodynamic instability, diagnosed with a duodenal ulcer via endoscopy. Initial management involved aggressive resuscitation with intravenous fluids, blood transfusions, proton pump inhibitors (PPIs), and tranexamic acid, followed by successful hemostasis through endoscopic hemoclipping. This case highlights the critical importance of early recognition, prompt resuscitation, and appropriate endoscopic intervention in pediatric UGIB. A comprehensive literature review is included to emphasize best practices and treatment strategies, particularly in resource-limited settings. This case contributes to the growing knowledge base on pediatric UGIB and offers valuable insights for improving clinical outcomes in similar cases.

Kenly Chandra, MD is a dedicated pediatric resident currently undergoing training at the Ospital ng Maynila Medical Center in the Philippines. With a background in medicine from Faculty of Medicine at Unika Atma Jaya in Indonesia, he is deeply committed to advancing pediatric healthcare. Dr. Chandra has contributed to several notable research projects, including studies on pediatric tuberculosis, childhood malnutrition, and pediatric epilepsy, among others. He has authored and co-authored numerous papers, such as the systematic review on the efficacy of probiotics for children with severe acute malnutrition. His ongoing research further extends to exploring pediatric duodenal varices and evaluating pediatric thyroiditis, showing his passion for addressing complex challenges in pediatric care.