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A retrospective survey of elderly patients admitted with perforation of a duodenal ulcer showed that some presented with typical symptoms and signs of a perforation, while others presented as a gastro-intestinal bleed or with confusion or malaise. Diagnosis tended to be delayed in the latter group and mortality was higher. Earlier diagnosis may be helped by taking a chest radiograph or lateral decubitus films of the abdomen with a repeat film in a few hours if the diagnosis is still being considered.
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COLEMAN et al. (1980) studied this question.
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