title: Perforated gastrointestinal ulcers presenting as acute respiratory distress.
abstract: BACKGROUND
  Dyspnea is one of the most common complaints facing the emergency medicine physician. Some of the gastrointestinal causes of dyspnea are self-limited and not life-threatening, yet others are, and early diagnosis and treatment are crucial.
  
  
  METHODS
  In this article we presented one of these life-threatening conditions through a clinical description of a patient presenting with acute respiratory distress that was finally diagnosed to be the result of a perforated gastric ulcer.
  
  
  RESULTS
  An emergent thoracotomy revealed a small ulcer with perforation in the fundus of the stomach. The patient was transferred after the operation to the intensive care unit and after a prolonged hospitalization discharged home. Biopsies taken from the ulcer showed diffuse inflammation, with no evidence of microorganisms or malignancy.
  
  
  CONCLUSIONS
  Perforation of gastric and duodenal ulcers is a rare yet existing cause of dyspnea and respiratory failure and should be kept in mind by the emergency physician, especially when other more common causes are ruled out.
authors.affiliation: Department of Emergency Medicine, Rambam medical center, Haifa, Israel.
authors.forename: Bennidor
authors.initials: B
authors.lastname: Raviv
authors.affiliation: Department of Emergency Medicine, Rambam medical center, Haifa, Israel.
authors.forename: Shlomo H
authors.initials: SH
authors.lastname: Israelit
keywords: Dyspnea; Gastric and duodenal ulcers; Perforation