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“Diagnosis and treatment of perforated peptic ulcer (Dr. S. Di Saverio MD) Introduction Every year peptic ulcer disease (PUD) affects 4
milion people around the world . Complications are encountered in 10%-20% of these patients and 2%-14% of the ulcers will perforate [2, 3]. Perforated peptic ulcer (PPU) is relatively rare, but life-threatening with the mortality varying from 10% to 40% [2, 4–6]. More than half of the cases are female and they are usually older and have more comorbidities than their male counterparts . Main etiologic factors include use of non-steroidal anti-inflammatory drugs (NSAIDs), steroids, smoking, Helicobacter pylori and a diet high in salt [3, 7]. All these factors have in common that they affect acid secretion in the gastric mucosa. Defining the exact etiological factor in any given patient may often be Copanlisib clinical trial difficult, as more than one risk factor may be present and they tend to interact .