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Article
January 13, 1934

PERFORATED PEPTIC ULCER WITH INTERMITTENT LEAKAGE

Author Affiliations

CHICAGO
From the Department of Medicine, University of Illinois College of Medicine, and the Cook County Hospital.

JAMA. 1934;102(2):112-117. doi:10.1001/jama.1934.02750020024006
Abstract

It is universally believed that, following the initial violent pain, the clinical picture and course of a perforated peptic ulcer are relatively uniform. The current teaching with regard to the symptomatology of ruptured ulcer subsequent to perforation may be summarized as follows: In the average case the intense pain of onset continues unabated unless relieved by large doses of morphine or by surgical intervention. If operation is not performed, the clinical picture of a diffuse suppurative peritonitis supervenes, preceded at times by a temporary subsidence of pain, the so-called period of quiescence or repose. In all but a small proportion of cases, generally stated to be less than 5 per cent, the infection progresses rapidly and leads to death within a few days. The small group of patients who recover from the diffuse, purulent peritonitis pass through a stormy convalescence during which surgical drainage of one or more intra-abdominal abscesses

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