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January 1960

Hemorrhagic Ascites Due to Perforated Duodenal Ulcer: Report of a Case

Author Affiliations

Portland, Ore.

From Department of Medicine, Veterans Administration Hospital (Dr. Bristow); Attending Physician in Gastroenterology, Veterans Administration Hospital (Dr. Medved).

AMA Arch Intern Med. 1960;105(1):105-107. doi:10.1001/archinte.1960.00270130121015

Only rarely do nonmalignant diseases produce hemorrhagic ascites. Among such benign causes are portal cirrhosis,1 pancreatitis,2 and portal vein thrombosis.

The following report describes a patient with hemorrhagic ascites due to a perforated duodenal ulcer with spontaneous localization. This complication of peptic ulcer is not mentioned in the recent literature or standard textbooks of gastroenterology.

Report of Case  The patient was a 48-year-old white man who entered the Portland, Ore., Veterans Administration Hospital on Aug. 19, 1957, with the chief complaint of abdominal swelling. He had been perfectly well until May, 1957, when he noted mild lower abdominal pain for one day. A similar episode occurred in early July, and in mid-July the pain recurred and was persistent. It was mildly cramping, made worse by eating, and improved slightly after defecation. Normally the patient had two formed stools daily, but with the development of the pain he passed