Perforated duodenal ulcer in a tropical African population.

Duodenal ulcer is common in tropical African countries. In many cases, the patients are first seen as cases of gastric outlet obstruction because, in this environment, people present at the hospital in late stages of disease. Perforated duodenal ulcer in this environment, however, has received very little attention in the literature because previously it was rarely seen. It is not unlikely that some cases of severe gastric outlet obstruction from chronic duodenal ulcer are due to unrecognized perforated duodenal ulcers that have healed.