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The famous Nobel Prize winning physicist is said to have died because

"A ruptured duodenal ulcer caused kidney failure",

leading to his death 12 days later. I understand that the kidney might have needed to do more filtration work due to this rupture, and maybe the ulcer contained some material too hard on the kidney, but how exactly does the contents of the ulcer spewing into the duodenum result lead to kidney failure? What are the steps that would occur that would lead to this outcome?

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Your stomach may contain bacteria that are harmless as long as they are in your digestive tract, but are potentially lethal if they get into other organs. A ruptured ulcer means that it's possible for the stomach contents to leak into the abdominal cavity and possibly the bloodstream. If the bacteria get established in you blood they will be carried to all the other organs creating a massive infection. The immune response to the infection may create a condition called sepsis. Sepsis is a well known complication from perforated ulcers and frequently leads to kidney failure.

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  • +1. Wow. In my head my conception of a ruptured duodenal ulcer as one on the inner wall of the duodenum rather than the outside. I had just always imagined ulcers to be on the inside, maybe because almost always when we see pictures of our GI tract it's via gastroscopy which looks at the inside. So an ulcer can be on the duodenum's outside lining and the contents can be spewed into the abdominal cavity, then what happens? It's been too long since I've done a disection and when I did I was so overwhelmed with the experience (and there wasn't much time to explore) that I feel I didn't learn much
    – user1271772
    Jun 30, 2020 at 18:00
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    The ulcer typically starts on the inside wall but sometimes works is way through the entire thickness of the tissue.
    – Charles E. Grant
    Jun 30, 2020 at 18:02
  • So there's bacteria that spew into the abdominal cavity, and then some of it can land on the kidney? I assume getting into the bloodstream could happen whether it spews into the cavity or into the inside of the duodenum, I mean bacteria can be small enough to penetrate blood vessels that are on the inner lining of the duodenum too right(?)
    – user1271772
    Jun 30, 2020 at 18:06
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    Most bacteria can't penetrate an intact blood vessel, but if an ulcer is perforated there is a good chance that some blood vessels will be compromised and perhaps provide access to the bacteria. The kidneys don't have to be infected themselves. They may be damaged by the sepsis resulting from an infection somewhere else. Check out the link I provided on sepsis.
    – Charles E. Grant
    Jun 30, 2020 at 18:11
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    Once the ulcer ruptures it will quickly reach the peritoneum which is well vascularised; and an untreated peritonitis will most certainly lead to sepsis, kidney failure and death. Perforated ulcers are similar to a perforated appendix or any abdominal perforation in that regard, and the peritoneum usually is the most sensitive tissue.
    – Narusan
    Jun 30, 2020 at 19:15

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