Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2017; 9(1): 1-12
Published online Jan 27, 2017. doi: 10.4240/wjgs.v9.i1.1
Perforated peptic ulcer - an update
Kin Tong Chung, Vishalkumar G Shelat
Kin Tong Chung, Vishalkumar G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Chung KT and Shelat VG contributed equally to Manuscript writing.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Vishalkumar G Shelat, FRCS, FICS, Hesperis Diploma in Organ Transplantation (ECOT), Hepatobiliary Consultant Surgeon, Department of General Surgery, Tan Tock Seng Hospital, Level 4, Annex 1, 11, Jalan Tan Tock Seng, Singapore 308433, Singapore.
Telephone: +65-63577807 Fax: +65-63577809
Received: July 19, 2016
Peer-review started: July 21, 2016
First decision: September 28, 2016
Revised: November 4, 2016
Accepted: November 27, 2016
Article in press: November 29, 2016
Published online: January 27, 2017
Core Tip

Core tip: The classic triad of sudden onset of abdominal pain, tachycardia and abdominal rigidity is the hallmark of perforated peptic ulcer. Early diagnosis, prompt resuscitation and urgent surgical intervention are essential to improve outcomes. Exploratory laparotomy and omental patch repair remains the gold standard and laparoscopic surgery should be considered when expertise is available. Gastrectomy is recommended in patients with large or malignant ulcer to enhance outcomes; however the outcomes of patients treated with gastric resections remain inferior.