Peptic ulcer perforation is a life threatening complication of peptic ulcer disease (PUD). 10%-20% of patients with peptic ulcer will develop complications, only 2%-14% of the ulcers will perforate [1,8]. Perforation is one of the commonest causes of emergency hospitalization and surgery in peptic ulcer disease [1]. Perforated peptic ulcer is associated with short term mortality and morbidity in up to 30% and 50% of the patients. The incidence of perforated peptic ulcer is approximately 7-10 per 10.000 populations per year [2,3]. An estimated 2% to 10% of patients with PUD will present with perforation of the stomach or the duodenum in their lifetimes, with a disproportionately high risk for mortality in the elderly [4,5]. Acute perforations of the duodenum are estimated to occur in 2-10% of patients with PUD [7,54].