title: Panendoscopic finding of perforated peptic ulcer (PPU).
abstract: OBJECTIVE
  The purpose of this research was to investigate whether endoscopy can identify specific signs in the area of the lesion in patients with undiagnosed perforated peptic ulcer.
  
  
  METHODS
  From February 1990 to September 1999, a total of 435 cases of perforated peptic ulcer were diagnosed after surgery at Changhua Show Chwan Memorial Hospital. Among them, 30 patients had received endoscopic examination before surgery and were diagnosed with perforated peptic ulcer during surgery.
  
  
  RESULTS
  One or more of the following signs were found by endoscopy in all patients: 1) a deep ulcer with a visible perforation hole (21/30, 70%); 2) formation of small air bubbles at the ulcer site (16/30, 53.3%); 3) duodenal bulb unable to dilate normally or at all during air inflation (12/30, 40%); and 4) exudative substance leaking from or covering the ulcer site (16/30, 60%).
  
  
  CONCLUSIONS
  Endoscopy cannot be applied as a routine method establishing a perforated peptic ulcer diagnosis. However, when the above signs are observed on endoscopy, the physician should highly suspect the presence of perforated peptic ulcer.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Changhua Show-Chwan Memorial Hospital, Taiwan, ROC.
authors.forename: Chia-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Yung-Hsiang
authors.initials: YH
authors.lastname: Yeh
authors.forename: Chi-Chieh
authors.initials: CC
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000175:diagnosis*; D012189:Retrospective Studies