Several factors have been attributed to the incidence of leaks after surgery for duodenal ulcer perforations, such as patient factors (age, shock on presentation, malnutrition, pre-existing comorbidities, low hemoglobin, and low serum albumin), poor surgical technique, large perforation size, delay in seeking medical attention, and delay in diagnosis and surgery14. The gene discussed is ALB; the disease is malnutrition.