title: Perforation of gastric ulcer associated with paraesophageal hernia causing diffuse peritonitis.
abstract: OBJECTIVE
  Free peritoneal perforation of a gastric ulcer associated with paraesophageal hernia causing diffuse peritonitis is an extremely rare event.
  
  
  METHODS
  Two new cases of this rare condition and the specificities of management are described.
  
  
  RESULTS
  One patient recovered well after surgery, while the other died with signs of persisting sepsis and multiple system organ failure.
  
  
  CONCLUSIONS
  In the wide spectrum of complications related to paraesophageal hernia, free peritoneal perforation of an associated ulcer seems to be one of the gravest. Early elective repair of the paraesophageal hernia is justified.
authors.affiliation: Department of Surgery, Twenteborg Hospital, Almelo, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Rakic
authors.forename: R J
authors.initials: RJ
authors.lastname: Hissink
authors.forename: B W
authors.initials: BW
authors.lastname: Schiff
mesh_terms: D000368:Aged; D005260:Female; D006551:Hernia, Hiatal / Q000150:complications*; D006801:Humans; D010439:Peptic Ulcer Perforation / Q000150:complications*; D010538:Peritonitis / Q000209:etiology*; D013276:Stomach Ulcer / Q000150:complications*