"Treatment is a surgical emergency, with patients requiring repair of the rupture 1-3. Postoperatively, management should consider and address the cause of the peptic ulcer (e.g. Helicobacter pylori eradication therapy) 1-3."
"localised pain, tenderness and guarding over the right lower abdominal quadrant"
"Radiographic investigations, such as ultrasound or CT, may be performed with acute appendicitis being the working diagnosis, and often reveal a normal or mildly inflamed appendix 1-5. However, patients may instead have radiographic features of a ruptured peptic ulcer, including subtle pneumoretroperitoneum, with accompanying free fluid and adjacent fat stranding demonstrable in the right paracolic gutter and around the appendix, reflecting the pathophysiological basis of the condition 2,4,5."