If a peptic ulcer perforates, air will leak from inside the gastrointestinal tract (which always contains some air) to the peritoneal cavity (which normally never contains air). This leads to "free gas" within the peritoneal cavity. If the person stands, as when having a chest X-ray, the gas will float to a position underneath the diaphragm. Therefore, gas in the peritoneal cavity, shown on an erect chest X-ray or supine lateral abdominal X-ray, is an omen of perforated peptic ulcer disease. Classification
Peptic ulcers are a form of acid–peptic disorder. Peptic ulcers can be classified according to their location and other factors. By location
Duodenum (called duodenal ulcer)
Esophagus (called esophageal ulcer)
Stomach (called gastric ulcer)
Meckels diverticulum (called Meckels diverticulum ulcer; is very tender with palpation)

Modified Johnson
Type I: Ulcer along the body of the stomach, most often along the lesser curve at incisura angularis along the locus minoris resistantiae. Not associated with acid hypersecretion. Type II: Ulcer in the body in combination with duodenal ulcers. Associated with acid oversecretion. Type III: In the pyloric channel within 3 cm of pylorus. Associated with acid oversecretion. Type IV: Proximal gastroesophageal ulcer. Type V: Can occur throughout the stomach. Associated with the chronic use of NSAIDs (such as ibuprofen). Macroscopic appearance
Gastric ulcers are most often localized on the lesser curvature of the stomach. The ulcer is a round to oval parietal defect ("hole"), 2–4 cm diameter, with a smooth base and perpendicular borders.
Prospective studies give a prevalence of 2-5 per 100 births of trabecular VSDs that close shortly after birth in 80-90% of the cases. Famous people who had ventricular septal defect
Madhubala (1933–69), Indian actress. Died at age 36. See also
Atrial septal defect
Atrioventricular septal defect
Cardiac output
Congenital heart disease
Heart sounds
Pulmonary hypertension

References


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