Clinical Manifestations of Gastric and Duodenal Ulcer Perforation

Patients with perforated gastric or duodenal ulcers typically present with sudden-onset upper abdominal pain, accompanied by nausea and vomiting. Physical examination reveals generalized abdominal tenderness, rebound tenderness, and muscular rigidity. In later stages, diffuse peritonitis may develop, manifesting as board-like abdominal muscle rigidity.

Laboratory tests often show elevated white blood cell count and increased neutrophil percentage on complete blood count; abnormalities in liver and renal function may also be observed. Abdominal radiography (flat plate) typically reveals free intraperitoneal gas beneath the diaphragm.Once the diagnosis is confirmed, prompt surgical intervention is indicated—typically exploratory laparotomy with perforation repair. In some cases, distal subtotal gastrectomy may be required.