An uncommon aetiology of perforated gastric ulcer
- aDivision of Gastroenterology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA, bDepartment of Internal Medicine, Brown University School of Medicine, Providence, RI, USA
- Aijaz Ahmed, MD, 180 Locksunart Way 5, Sunnyvale, CA 94087, USA
- Accepted 8 July 1998
A 75-year-old woman presented with an 8-hour history of severe, progressively worsening, abdominal pain. The pain was described as diffuse, burning in nature, and associated with nausea. The patient had been in her usual state of health prior to the onset of symptoms. She denied haematemesis, melaena, or haematochezia. The patient's medical history was significant for Parkinson's disease and depression. There was no history of peptic ulcer disease. On examination, her blood pressure was 123/52 mmHg, pulse rate 126 beats/min, temperature 36.5°C, and respiratory rate 24 breaths/min. The abdomen was soft, diffusely tender and moderately distended. Bowel sounds were hypoactive. Rebound and rigidity were absent. Rectal examination revealed guaiac negative, brown stool. The remainder of the examination was unremarkable. Laboratory data showed a white cell count of 25.8 × 109/l and haemoglobin 120 g/l. Coagulation studies, platelet count and routine chemistries were normal. Abdominal X-rays revealed free air under the …
