A perforated ulcer, is a very serious condition where an untreated ulcer can burn through the wall of the stomach (or other areas of the gastrointestinal tract), allowing digestive juices and food to leech into the abdominal cavity. Treatment generally requires immediate surgery. The ulcer is known initially as a peptic ulcer before the ulcer burns through the full thickness of the stomach or duodenal wall. A diagnosis is made by taking an erect abdominal/chest X-ray (seeking air under the diaphragm). This is in fact one of the very few occasions in modern times where surgery is undertaken to treat an ulcer. Many of the perforated ulcers have been attributed to the bacterium Helicobacter pylori. The incidence of perforated ulcer is steadily declining, though there are still incidents where it occurs. Causes include smoking and non-steroidal anti-inflammatory drugs (NSAIDs). A perforated ulcer can be grouped into a stercoral perforation which involves a number of different things that causes perforation of the intestine wall.
Herman Pauling (1876–1910, aged 33) suffered from a perforated ulcer with attendant peritonitis and died on June 11, 1910.
Rudolph Valentino (1895–1926, aged 31) suffered from a perforated ulcer and died on August 23, 1926.
Rudyard Kipling (1865–1936, aged 70) died of perforated duodenal ulcer on 18 January 1936.
J. R. R. Tolkien (1892–1973, aged 81) suffered from a perforated ulcer and died on September 2, 1973.
Albert Blithe (1923–1967, aged 44) suffered from a perforated ulcer and died on December 17, 1967.
Philip Agee (1935–2008, aged 72) suffered from a perforated ulcer and died on January 7, 2008.
James Joyce (1882–1941, aged 58) suffered from a perforated ulcer and died on January 13, 1941, in Zürich.
Ian Hendry (1931—1984, aged 53) Hendry died of a stomach haemorrhage in London, aged 53.
Doug Hepburn (1926–2000, aged 74) suffered from a perforated ulcer and died on November 22, 2000.
Charlie Parker (1920–1955, aged 35) suffered from a perforated ulcer, and died on March 12, 1955.
Barbara Bush (born 1925) was treated for a perforated ulcer in November 2008.
Peter Jackson (born 1961) underwent surgery for a perforated ulcer in January 2011, coincidentally during production of adapting J.R.R. Tolkien's The Hobbit to screen.