Foregut and Hindgut Perforations

The epidemiology of intestinal perforations has changed significantly over the past half century due to numerous factors ranging from diet to therapeutic medications and increasing life span. Some conditions like peptic ulcer disease have been significantly reduced in incidence from widespread acid suppression, while inflammatory disorders including diverticulitis and inflammatory bowel disease have significantly increased. Our tools for addressing the biology of sepsis and source control have out of necessity evolved to solve the increasingly complex physiologies that we now encounter. This chapter reviews the modern treatment of perforations occurring across the gastrointestinal tract.