Management of perforated peptic ulcer: What you need to know.

Rasslan, Samir; Coimbra, Raul; Rasslan, Roberto; Utiyama, Edivaldo M · J Trauma Acute Care Surg · 2025

review · Level V

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Abstract

Despite therapeutic advancements and the significant efficacy of medical management, peptic ulcer disease still affects millions of people. Elective surgical treatment, once a common intervention in General Surgery departments, is now nearly obsolete. Surgical treatment is reserved solely for complications, which occur in approximately 10% to 20% of cases. Perforation is the most common indication for surgery in peptic ulcer disease and accounts for nearly 40% of deaths from the disease. Treatment success depends on various factors, with early diagnosis and immediate surgical intervention being highlighted. Perforation is associated with a high incidence of morbidity and mortality. This article aims to analyze the different aspects related to the treatment of perforated peptic ulcers and define the best therapeutic approaches.

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