Perforation is one of the common surgical complications of peptic ulcer diseases despite the use of various anti-ulcer agents and eradication therapy1 . Important etiological factors in the perforation of peptic ulcer diseases are infection with H.pylori, followed by chronic NSAIDS intake, chronic alcohol intake, cigarette smoking, smoked foods as in Japan people use smoked fish, spicy foods, irregular diet intake and in type A personalities1 . Anterior ulcers perforate usually and bleeds rarely while posterior ulcers penetrates and bleeds2 . Peptic ulcer perforation is rare before adolescence, common in 30-40years of age group, and is more common in men than Women3 . Abdominal pain, cardinal symptom of perforation is sudden in onset and may wake up the patient from sleep, tearing type, starts in the epigastrium and radiates to tip of the shoulder4,5. Various tests are used in the diagnosis of etiology of peptic ulcer. The sensitivity and specificity of these diagnostic tests is different. In this study we will determine the efficacy of different diagnostic tests considering histopathology as gold standard.
