<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 57-year-old woman comes to the physician because of a 2-week history of worsening epigastric pain that improves with meals. She has had similar pain of lesser intensity for the past 4 years. Physical examination shows no abnormalities. Upper endoscopy shows a 0.5-cm mucosal breach in the anterior duodenal bulb that extends into the submucosa. A biopsy specimen of the lesion shows hypertrophy of the Brunner glands. This patient is at the greatest risk for which of the following complications?? A: Perforation, B: Hematemesis, C: Gastric outlet obstruction, D: Adenocarcinoma, E: Pernicious anemia,  <response>: This is a clinical vignette describing a 57-year-old woman with a 2-week history of epigastric pain that improves with meals. She has a longstanding history of similar pain. Endoscopy shows a mucosal breach in the duodenal bulb and biopsy shows Brunner gland hypertrophy. This indicates the patient likely has a benign duodenal ulcer caused by increased acid production. The question asks about the most likely complication of this condition. Perforation, hematemesis, and gastric outlet obstruction are all potential complications of peptic ulcers. Pernicious anemia is not associated with ulcers. Adenocarcinoma is unlikely given the benign appearing biopsy. Therefore, the most likely complication in this patient is perforation of the ulcer into the abdominal cavity.A: Perforation 