A straightforward case of bowel perforation with typical clinical presentation and confirmatory pneumoperitoneum on standing plain x-ray. The exact site of perforation was nicely demonstrated on CT study with oral contrast, with leakage of oral contrast into the peritoneal space at the first part of the duodenum.

Gastric and duodenal ulcers usually have similar risk factors and both can be complicated by perforation, however they may vary a little bit in their clinical presentation.