Perforated peptic ulcer

Perforation of a peptic ulcer can cause acute abdominal pain both with and without a prior history of peptic ulcer. It is an acute surgical emergency requiring immediate diagnosis. Consider a history of drugs, especially NSAIDs and H2 antagonists. Perforated ulcers may follow a heavy meal. There is usually no back pain.

The maximal incidence is 45-55 years, most common in males, and a perforated duodenal ulcer is more common than a gastric ulcer. Consider the clinical syndrome in 3 stages:

1. prostration

2. reaction (after 2-6 hours)—symptoms improve

3. peritonitis (after 6-12 hours)

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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