A 62-year-old man known to have a duodenal ulcer developed diffuse abdominal pain. The anterior abdominal wall was tender on palpation. X-ray examination revealed air under the diaphragm
Which of the well-known complications of peptic ulcer accounts for this clinical finding?
A. penetration into the pancreas
B. perforation of the ulcer
C. stenosis of the duodenum
D. hemorrhage
E. melena
B
Perforation of the peptic ulcer has most likely caused peritonitis, which accounts for abdominal pain and tenderness on palpation. Free air under the diaphragm proves that a perforation really occurred, allowing the air from the inside of the intestine to exit into the abdominal cavity.
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Fill in the blank(s) with the appropriate word(s).