The board-like abdomen, characteristic of a perforation of a peptic ulcer, has always been described by the surgeon as being secondary to an "acid-peritonitis." Seemingly, this statement found its place in medical literature many years ago and, like many other statements, does not appear to have a basis in factual observation.
Methods and Materials
The current study consists of measurement of the pH of the peritoneal fluid in 59 patients who were found to have had an acute perforation of a peptic ulcer. The fluid was taken at laparotomy as soon as the peritoneum was incised, and the pH was measured using Nitrazine paper or a Beckman pH meter.Each of the patients studied gave a history indicative of free perforation within 24 hours of the time of operation. Almost all of the patients had boardlike rigidity immediately prior to operation. In several instances the ulcer had sealed spontaneously, but,
HOWARD JM, SINGH LM. Peritoneal Fluid pH After Perforation of Peptic Ulcers: The Myth of "Acid-Peritonitis". Arch Surg. 1963;87(3):483–484. doi:10.1001/archsurg.1963.01310150119027
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