Occurs when an untreated ulcer burns through the mucosal wall of the stomach or duodenum, allowing gastric contents to leak into the abdominal cavity

Clinical features

• Sudden severe onset abdominal pain
• Localised/generalised peritonitis
• Signs of SIRS
• Immobile abdomen - board-like rigidity

Investigations

• CXR/AXR - pneumoperitoneum
• CT abdo/pelvis - signs of perforation, pneumoperitoneum

Management

• Surgery