What is the major complication associated with perforation of gastric ulcers?

Perforation of gastric ulcers leads to the exposure of the gastric contents to the peritoneal cavity, which can result in peritonitis. This condition is characterized by inflammation of the peritoneum, the lining of the abdominal cavity, and can develop rapidly after perforation occurs.

When the ulcer perforates, gastric acid, along with food and bacteria from the stomach, spills into the sterile peritoneal cavity, triggering a strong inflammatory response. This can cause severe abdominal pain, nausea, vomiting, and typically requires immediate medical attention, often resulting in surgical intervention.

While internal bleeding, sepsis, and obstruction can sometimes occur as complications of gastric ulcers, they are not as directly associated with the acute situation arising from a perforation. Internal bleeding typically arises from a bleeding ulcer, sepsis may result from untreated infections, and obstruction may occur due to scarring or inflammation over time, rather than as a direct consequence of perforation.