title: Perforated peptic ulcer (PPU) in pregnancy during Ramadan fasting.
abstract: BACKGROUND
  Perforated Peptic Ulcer (PPU) is extremely rare in pregnancy. We report a case of perforated peptic ulcer in pregnancy during Ramadan fasting.
  
  
  METHODS
  The patient is a 16 years old primigravida who presented with features of peritonitis at 28weeks of gestation while fasting during Ramadan. Ultrasound scan reported a singleton live fetus at 28 weeks gestation. At laparotomy via upper midline incision; a 1 cm roundish perforation located on the duodenum anteriorly was found with about a litre of gastric juice mixed with blood and food particles in the peritoneal cavity. The perforation was close transversely with omental patch (Modified Graham's patch) and peritoneal lavage done with warm saline. She had a preterm delivery of a 1 kg baby 3 days post-operatively by a spontaneous vaginal delivery, but the baby died 3 days later.
  
  
  CONCLUSIONS
  Perforated Peptic Ulcer(PPU) though rare in pregnancy can occur and fasting can be a risk factor.
authors.affiliation: Department of Surgery, University of Maiduguri Teaching Hospital, PMB 1414 Maiduguri, Borno State, Nigeria. mbgali@yahoo.com
authors.forename: B M
authors.initials: BM
authors.lastname: Gali
authors.forename: A G
authors.initials: AG
authors.lastname: Ibrahim
authors.forename: C M
authors.initials: CM
authors.lastname: Chama
authors.forename: H B
authors.initials: HB
authors.lastname: Mshelia
authors.forename: A
authors.initials: A
authors.lastname: Abubakar
authors.forename: I U
authors.initials: IU
authors.lastname: Takai
authors.forename: U
authors.initials: U
authors.lastname: Takie
authors.forename: S
authors.initials: S
authors.lastname: Bwala
mesh_terms: D000293:Adolescent; D005215:Fasting / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007514:Islam; D007813:Laparotomy; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000601:surgery*; D011256:Pregnancy Outcome; D016896:Treatment Outcome