Drug consumption before perforation of peptic ulcer

In a retrospective study of 195 patients with a perforated peptic ulcer 18 per cent of the patients had taken aspirin, phenylbutazone or corticosteroids during the period before the perforation. In a controlled prospective trial, 18 of 22 patients (82 per cent) had taken drugs known to be potentially harmful to the stomach. Aspirin was the drug mainly used. Thirteen of 22 patients had taken the drugs within 12 hours of the perforation, usually because of symptoms not related to the gastro-intestinal tract. Drug consumption and perforation of pre-pyloric ulcers were most closely associated; the latter applies particularly to female patients, who either had only a short history of upper gastro-intestinal dyspepsia or were asymptomatic.