Sudden Severe Epigastric Pain in Medicine / Internal Medicine — 72yo Man | Gastroenterology | SMLE Q#18313

SMLE Question #18313

Medicine / Internal Medicine Gastroenterology

Objective: OBJ-PEUD-001

Last updated: February 2026
A 72-year-old man presents with sudden severe epigastric pain and a rigid abdomen. He undergoes emergency laparotomy where a perforated anterior duodenal ulcer is repaired with an omental patch. He has chronic knee osteoarthritis treated with daily naproxen and is not taking antiplatelets or anticoagulants. Intraoperative testing for Helicobacter pylori is negative. He is discharged on proton pump inhibitor therapy. Which preventive measure is most important to reduce recurrent peptic ulcer disease and its complications?

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