<Li> Gastrointestinal bleeding is the most common complication . Sudden large bleeding can be life - threatening . It occurs when the ulcer erodes one of the blood vessels, such as the gastroduodenal artery . </Li> <Li> Perforation (a hole in the wall of the gastrointestinal tract) often leads to catastrophic consequences if left untreated . Erosion of the gastro - intestinal wall by the ulcer leads to spillage of the stomach or intestinal content into the abdominal cavity . Perforation at the anterior surface of the stomach leads to acute peritonitis, initially chemical and later bacterial peritonitis . The first sign is often sudden intense abdominal pain; an example is Valentino's syndrome, named after the silent - film actor who experienced this pain before his death . Posterior wall perforation leads to bleeding due to the involvement of gastroduodenal artery that lies posterior to the first part of the duodenum . </Li> <Li> Penetration is a form of perforation in which the hole leads to and the ulcer continues into adjacent organs such as the liver and pancreas . </Li> <Li> Gastric outlet obstruction is a narrowing of the pyloric canal by scarring and swelling of the gastric antrum and duodenum due to peptic ulcers . The person often presents with severe vomiting without bile . </Li>

Signs and symptoms of peptic and duodenal ulcer