Five diagnostic indicators, including three signs and symptoms
of PUP (intense abdominal pain, tenderness, and
guarding) were significantly different from peptic ulcer
patients with no perforation. In the literature,2 it is suggested
that gastrointestinal perforation often leads to catastrophic
consequences.
Erosion of the gastrointestinal wall by the
ulcer leads to spillage of stomach or intestinal content into
the abdominal cavity. Perforation at the anterior surface of the
stomach leads to the first sign which is often sudden intense
abdominal pain. Posterior wall perforation leads to tenderness
and guarding, which often radiates pain to the back.