Abstract
Introduction Peptic ulcer usually presents to the emergency in the form of an acute abdomen, which
is usually diagnosed easily either clinically or radiologically. Although its incidence
has decreased with the introduction on proton pump inhibitors it is still one of the
most common emergencies encountered by a surgeon.
Case Presentation A 60-year-old woman complained of epigastric swelling for 6 months which gradually
increased and became irreducible over the last 2 months. The patient also complained
of pain associated with vomiting. Radiological investigations revealed a epigastric
hernia with omentum and stomach as content along with fluid collection in the right
perihepatic region, with tiny air foci. The patient was explored for the same.
Discussion Perforated peptic ulcer is a serious complication and carries high risk of morbidity
and mortality. Early diagnosis with immediate resuscitation and surgical intervention
is essential to improve outcomes. This is a rare case of perforated gastric ulcer
which was masked under the complicated ventral hernia.
Keywords
peptic ulcer - gastric ulcer perforation - irreducible ventral hernia - Graham's patch
technique
