[Perforation of cancer or stomach ulcer: a 1- or 2-stage operation]

The results of simple closure were compared with those of partial resection in the treatment of acute gastric perforation in 13 patients. Perforation was due to ulcer in 10 cases and to cancer in 3 cases. Differential diagnosis between cancer and ulcer during emergency surgery is difficult to establish and could be made in 2 cases only postoperatively. In the 8 patients undergoing gastric resection there was one fatal outcome by pulmonary embolism. In 5 patients where the perforation was only sutured, one patient aged 97 died of pneumonia. 2 patients developed severe hemorrhage and needed an emergency gastric resection, that was survived by only one patient. - Our results and those of the literature suggest that in acute gastric perforation due to ulcer or carcinoma, emergency gastric resection gives far better results than simple closure by suture.