THE INCIDENCE OF HEMORRHAGE OCCURRING WITH PERFORATION IN PEPTIC ULCER

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Abstract
The impression that bleeding ulcers do not perforate and ulcer perforations do not bleed seems to be generally accepted by physicians and surgeons as true. That occurrence of bleeding and perforation together is uncommonly encountered is inferred from references stating that it is well known that bleeding ulcers rarely perforate and vice versa1or that bleeding and perforation rarely occur together.2Finsterer,3in a vast experience, reported finding hemorrhage and perforation occurring together only three times. Blackford and his associates4concluded "bleeding ulcers don't perforate; and ulcer perforations don't bleed." James and Matheson,5however, reported hemorrhage in the presence of perforation of a peptic ulcer and, again, hemorrhage which followed surgical resection of a peptic ulcer. They questioned the validity of the accepted impression. Bleeding that occurs with peptic ulcer may be described as massive, moderate or slight. The massive hemorrhage is usually sudden in

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