Recurrent<unk> ations in the stomach and proximal duodenum
Defect in the gastric or duodenal wall that extends through the muscularis mucosa into the deeper layers of the wall
Majority of cases related to H. pylori or NSAID use
H. pylori found in 30-40% of U.S. population
NSAIDs inhibit prostaglandin synthesis (decreases mucus and bicarb production)
Perforation most commonly occurs in anterior wall of duodenum.
Defect in the gastric or duodenal wall that extends through the muscularis mucosa into the deeper layers of the wall
H. pylori found in 30-40% of U.S. population
NSAIDs inhibit prostaglandin synthesis (decreases mucus and bicarb production)
Peptic ulcer disease
Gastroesophageal reflux disease 
Gastritis
Peptic ulcer disease with or without perforation
Gastroesophageal reflux disease
Lower gastrointestinal bleeding
Pancreatitis
Gallbladder disease 