In a recent article by Behrman1 on the management of complicated peptic ulcer disease, he contends that “deviation from traditional surgical management might prove detrimental should other nonoperative modalities be used.” This might be true in select cases, however, it is not applicable to the majority of peptic ulcer perforations.
Nonoperative management has yielded successful results in sealed perforated diverticulitis, sealed Boerhaave syndrome, and sealed perforated appendicitis. The same should follow for sealed perforated peptic ulcer disease.
Liang MK, Marks JL, Berman RS, Carter J. Management of Complicated Peptic Ulcer Disease. Arch Surg. 2005;140(9):914-915. doi:10.1001/archsurg.140.9.914-b