Emergency bowel surgery in the elderly.

Area of Science:

• Gastroenterology
• Geriatric Surgery
• Surgical Outcomes

Background:

• Emergency bowel operations are high-risk procedures, especially for elderly patients.
• These operations are frequently performed in emergency settings.
• Elderly patients face elevated morbidity and mortality risks from bowel emergencies.

Purpose of the Study:

• To review the presentation, management, and outcomes of bowel emergencies in patients over 65 years old.
• To analyze factors influencing the management and outcomes of emergency bowel operations in the elderly.
• To identify common causes and associated risks of bowel emergencies in geriatric populations.

Main Methods:

• Retrospective review of 248 patients (age > 65) who underwent emergency bowel surgery over five years.
• Analysis of patient demographics, clinical presentation, medical history, comorbidities, and surgical procedures.
• Statistical evaluation using SPSS 9.0, with significance set at p < 0.05.

Main Results:

• The study included 248 patients with a mean age of 72.5 years.
• Small bowel emergencies (SBE) constituted 34% (mesenteric ischemia, adhesions), and large bowel emergencies (LBE) 62% (malignancy, sigmoid volvulus).
• Obstruction (65%) and perforation (19%) were common presentations; high resection rates were noted for malignancy, volvulus, and ischemia. Overall morbidity was 42% and mortality was 28%.

Conclusions:

• Emergency bowel operations in the elderly are associated with poor outcomes.
• Disease nature, extent, cardiopulmonary comorbidities, delayed admission, and peritonitis significantly impact outcomes.
• Optimizing management strategies for elderly patients with bowel emergencies is crucial.