In the majority of the situations, a perforated ulcer presents itself in an acute emergency situation with severe abdominal pain. The treatment is surgery to either seal the perforation or to resection the portion of bowel that has perforated. This may be done via laparoscopic (keyhole) approach.
In a very small proportion of patients, the presentation may be delayed for whatever reasons and the patient may no longer experience severe pain and it is possible that nature has taken its course to seal the perforation. In such cases, it may be possible not to have surgery but to monitor for complications and address such complications if they are present. Most commonly, such patients may develop an abdominal abscess which will then have to be drained.
