Gastric perforation is a serious and potentially fatal complication of prolonged or improper use of non-steroidal anti-inflammatory drugs (NSAIDs). Their primary mechanism involves the inhibition of prostaglandin synthesis, which reduces mucosal protection and promotes the formation of ulcers susceptible to perforation. We report the case of a 30-year-old male who, after taking etoricoxib and then self-medicating with diclofenac for two weeks, developed progressive colicky abdominal pain along with nausea and general malaise. One day prior to admission, the pain suddenly became persistent and severe, accompanied by vomiting, abdominal distension, sweating (diaphoresis), and shortness of breath (dyspnea). On examination, he had a distended abdomen, a positive Blumberg sign (rebound tenderness), and severe epigastric pain. An X-ray showed pneumoperitoneum (air in the abdominal cavity), pro...