{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T03:13:16Z","timestamp":1774321996859,"version":"3.50.1"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Peptic ulcers and complications, such as perforation, are rare during pregnancy and the puerperium. Accordingly, many clinicians may place these diagnoses low on their differential diagnosis. We present two case reports of primigravida, advanced maternal-age females with a history of irritable bowel syndrome and nonsteroidal anti-inflammatory drug use found to have perforated duodenal ulcers after cesarean section. Postpartum surgical abdomens may not present with classic guarding and rigidity. A low threshold for imaging and identification of risk factors is critical to timely diagnosis and management.<\/jats:p>","DOI":"10.1055\/a-2533-2017","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:27:51Z","timestamp":1738801671000},"page":"e32-e35","source":"Crossref","is-referenced-by-count":1,"title":["Duodenal Peptic Ulcer Perforation in the Puerperium Case Report Series"],"prefix":"10.1055","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5494-3889","authenticated-orcid":false,"given":"Elizabeth","family":"Stiles","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Surgery, NYU Langone Health, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Fleury","sequence":"additional","affiliation":[{"name":"Department of Surgery, NYU Langone Health, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Rubenstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, NYU Langone Health, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"issue":"03","key":"ref1","first-page":"290","article-title":"Peptic ulcer and pregnancy; deaths from perforation and hemorrhage of peptic ulcer during pregnancy","volume":"2","author":"J L Johnston","year":"1953","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0889-8553(02)00063-8","article-title":"Gastric and duodenal ulcers during pregnancy","volume":"32","author":"M S Cappell","year":"2003","journal-title":"Gastroenterol Clin North Am"},{"issue":"5998","key":"ref3","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1136\/bmj.4.5998.691","article-title":"Abdominal surgical emergencies in the puerperium","volume":"4","author":"A Munro","year":"1975","journal-title":"BMJ"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s00404-008-0722-4","article-title":"Perforated duodenal ulcer in the puerperium","volume":"279","author":"S Engemise","year":"2009","journal-title":"Arch Gynecol Obstet"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","first-page":"rjaa459","DOI":"10.1093\/jscr\/rjaa459","article-title":"A unique presentation of perforated duodenal ulcer in a postpartum woman: a case report","volume":"2020","author":"A Jain","year":"2020","journal-title":"J Surg Case Rep"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1080\/01443610410001722789","article-title":"Postpartum abdominal pain\u2013have you excluded a perforated ulcer?","volume":"24","author":"E K Tan","year":"2004","journal-title":"J Obstet Gynaecol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"bcr0620103103","DOI":"10.1136\/bcr-06-2010-3103","article-title":"Postpartum pneumoperitoneum: an important clinical lesson","volume":"2012","author":"S Miles Dua","year":"2012","journal-title":"BMJ Case Rep"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3109\/01443615.2015.1036412","article-title":"Postpartum duodenal perforation after acute fatty liver of pregnancy","volume":"36","author":"S Maruyama","year":"2016","journal-title":"J Obstet Gynaecol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s12893-020-00732-9","article-title":"Peptic ulcer perforation after cesarean section; case series and literature review","volume":"20","author":"M Shirazi","year":"2020","journal-title":"BMC Surg"},{"issue":"1516","key":"ref10","first-page":"97","article-title":"Post-partum duodenal perforation","volume":"133","author":"A D Bartolo","year":"2020","journal-title":"N Z Med J"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1213\/ANE.0000000000005257","article-title":"Society for obstetric anesthesia and perinatology: consensus statement and recommendations for enhanced recovery after cesarean","volume":"132","author":"L Bollag","year":"2021","journal-title":"Anesth Analg"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/ijcp.12634","article-title":"Should patients prescribed long-term low-dose aspirin receive proton pump inhibitors? 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