The key is the free air in the abdominal cavity. Ulcers, especially duodenal ulcers, can perforate into the abdominal cavity. This can cause a pneumoperitoneum (free air under the diaphragm). Not a listed symptom in this question, but this can also cause referred pain to the shoulder by irritating the phrenic nerve. FA 2019 pg 374
et-tu-bromocriptineTo add on to this, anterior* duodenal ulcers tend to perforate (makes sense because closest to the abdominal cavity) whereas posterior duodenal ulcers tend to bleed (due to proximity to the gastroduodenal artery).+15
smc213Acute pancreatitis can also occur with a posterior duodenal ulcer rupture. Source: Pathoma+6
victor_abdullatifFun fact: anterior duodenal perforation are more common than posterior because of the physics of the flow of chyme from the stomach into the duodenum. It travels in a manner that hits the anterior portion of the duodenum, therefore leading to ulcer / perforation.+2
submitted by โimnotarobotbut(184)
The key is the free air in the abdominal cavity. Ulcers, especially duodenal ulcers, can perforate into the abdominal cavity. This can cause a pneumoperitoneum (free air under the diaphragm). Not a listed symptom in this question, but this can also cause referred pain to the shoulder by irritating the phrenic nerve. FA 2019 pg 374