Abstract
Aim: To highlight the value of repeat plain X ray abdomen in duodenal ulcer perforation.
Case report: 60 year old female patient was admitted with duodenal perforation with negative X-ray at the time of admission. Later the same investigation revealed pneumoperitoneum.
Discussion: Pneumoperitoneum may not be evident in all duodenal ulcer perforations immediately after admission. In such occasions, repeat plain X ray abdomen may clinch the diagnosis.
Conclusion: The value of repeat X-ray in suspected cases of perforation is stressed in this case scenario.

Key words: duodenal ulcer perforation, repeat plain X ray abdomen