Which symptom is associated with perforation of a gastric ulcer?

Severe epigastric pain is strongly associated with the perforation of a gastric ulcer. When a gastric ulcer perforates, it allows gastric contents to leak into the abdominal cavity, which can lead to peritonitis. This sudden, intense pain often occurs in the epigastric region and is usually described as sharp or stabbing. It may also be accompanied by other signs such as rigidity of the abdominal muscles and potential signs of shock.

Understanding the characteristics of the pain helps differentiate it from other types of abdominal pain. For example, the pain associated with perforated gastric ulcers is acute and severe compared to symptoms like a dull abdominal ache or left flank pain, which do not typically indicate a gastric perforation. Referred shoulder pain may occur in other situations, such as diaphragmatic irritation, but it is not the primary symptom one would expect with a perforated gastric ulcer.