Perusal of the medical literature impresses one with the infrequency of references to perforation as a complication of gastric carcinoma. However, admission to the hospital of 2 patients with acute gastric perforation within one week was considered to be of sufficient interest to warrant presentation of the cases, with a review of those observed in the St. Louis City Hospital during the past ten years. Perforated peptic ulcers of the stomach present a more familiar surgical emergency, occurring in approximately 15 per cent of cases.1 Preoperatively, differentiation between the types of perforation may be difficult if not impossible, because little if any time is afforded the various differential procedures, such as analysis of the gastric contents and complete roentgen studies.
The most comprehensive of the reports in the recent literature is that of McNealy and Hedin,2 who reviewed 133 cases of perforation of gastric carcinoma. The incidence of