The Authors present 15 cases of simultaneous or consecutive gastroduodenal hemorrhage and perforation. The frequency with which these associated formsoccurs vary from 3 to 5 %, though the international Iiterature states a higher number of cases. Difficulties in diagnosis are analized because thedeiayed diagnosis is due to not considering the associated forms, and therefore not looking for it in every patient who <loes not evolve in the usual way. It is also demonstrated that delay in diagnosis produces high mortality for serious complications. They consider the incidence, whether simultaneously or consecutively, as well as the anatomic varietiesof the single, double or extensive ulcers which provoke them. A more radical initial approach is proposed by treating each of these complicatio'ns separately as away of preventing further compl'ications. The logical therapeutics for the stated associated complications is the radical treatment of ulcerous conditions, gastrectomy, vagotomy and pyloroplastia o·r combinations of these. Conservative metho'ds, are discused accord to the high number of patients treated by simple closure of perforation who had to undergo further Surgery. 

Los autores presentan 15 casos rde asociación de perforación y hemorragia gastroduodenal, simultánea o sucesiva. La frecuencia de esta asociación lesiona! oscilaentre un 3 y un 5 %, aunque ,existen cifras mayores en la literatura internacional. Analizan la dificultad diagnóstica, que es real, aunque inte!l'viene en el retardo diagnóstico,la falta de costumbre die pensar y buscar dicha asociación lesiona! en todo enfermo que no evolucione como habitualmente. Se de muestra que el retardo diagnóstico ,genera unaelevada mortalidad, de la grave complicación. Analizan las formas en que se presentan, s