Perforated peptic ulcer (PPU) is a common surgical emergency. Early di
agnosis and intervention are necessary to reduce the morbidity and mor
tality. Radiographic or sonographic detection of free air is neither s
ensitive nor specific for PPU. We report a case of sealed-off PPU with
direct sonographic demonstration of the perforation tract within the
anterior wall of the gastric antrum. The diagnosis was confirmed at la
parotomy. (C) 1998 John Wiley & Sons, Inc.