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Free perforation of marginal ulcers.

The problem of marginal ulcer is of such absorbing interest that it has engaged the attention of investigators over many years. Although it is recognized that free perforation of marginal ulcer is one of the complications, little attention has been paid to this subject. In the first half of this century several papers recorded cases of free perforation of marginal ulcer, and by 1944 there were a total of 217 collected cases. 1 Since that time there has been only one isolated case report in the English literature. 2 The literature on marginal ulcer occasionally mentions free perforations. Beal, in his monograph, 3 records 11 free perforations in 204 patients, of which six perforations were in patients who had had only a gastrojejunostomy and five were in patients who had had subtotal gastrectomy. Smith and Strange 4 recorded two instances of free perforation in a total of 20 cases, and