Typical clinical features

See Figure 30.13 . Typical clinical features are:

• sudden onset severe epigastric pain

• continuous pain but lessens for a few hours

• epigastric pain at first, and then generalised to whole abdomen

• pain may radiate to one or both shoulders (uncommon) or right lower quadrant

• nausea and vomiting (delayed)

• hiccough is a common late symptom sudden severe pain aiuious, sUll, ■"grey"', sweaty deceptive Improvement

Fig. 30.13 Typical features of perforated peptic ulcer

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