Elderly man who presented with hematemesis (vomiting blood) and melena (black, tarry stools). Endoscopy revealed three gastric ulcers. At the base of one ulcer was this perforation, which required surgical intervention.
65 year-old man who presented with abdominal pain and hematemesis. Abdominal exam was relatively benign, and abdominal xrays had not been suggestive of perforated viscus. Endoscopy revealed a chronically perforated gastric ulcer, through which the liver was visible.
SOURCE:Atlanta South Gastroenterology.