Gastric and Duodenal Perforation in Elderly

Etiologies associated with gastric and duodenal perforation in the elderly are multiple: peptic ulcer disease, iatrogenic causes, gastric cancer, perforation of duodenal diverticulum, foreign bodies, and trauma. The main cause of perforation in elderly people is peptic ulcer disease. Perforation of a peptic (gastric or duodenal) ulcer is a potentially fatal surgical emergency that remains a formidable health burden worldwide (Savens, World J Surg 24:277–283, 2000). The global prevalence of peptic ulcer disease has decreased in recent decades, but this has not been followed by a similar reduction in complications from peptic ulcer: despite the introduction of PPIs, the rate of peptic ulcer perforation has remained stable in several regions of the world and the most patients with a peptic ulcer perforation are elderly with considerable comorbidity. Perforation of upper gastrointestinal tract remains a frequent challenge to surgeons and optimal treatment strategies are needed.