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Abdominal surgical emergency in the elderly.

Günay Gürleyik1, Emin Gürleyik, Selçuk Unalmişer

  • 1Haydarpasa Numune Hospital, Department of Surgery, Istanbul. esg@e-kolay.net

The Turkish Journal of Gastroenterology : the Official Journal of Turkish Society of Gastroenterology
|December 27, 2005
PubMed
Summary

Elderly patients face serious risks from abdominal surgical emergencies, with preventable conditions like cholecystitis and hernias being most common. Acute mesenteric ischaemia, GI bleeding, and perforation carry the worst prognoses in this demographic.

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Area of Science:

  • Geriatric Surgery
  • Abdominal Surgery
  • Surgical Emergencies

Background:

  • Increasing life expectancy necessitates greater surgical care for the elderly.
  • Abdominal surgical emergencies pose significant life-threatening risks to older adults.

Purpose of the Study:

  • To evaluate the characteristics and outcomes of elderly patients undergoing emergency surgical treatment.
  • To identify common causes and mortality factors in geriatric abdominal surgical emergencies.

Main Methods:

  • Retrospective analysis of 181 patients aged 60 years and above.
  • Data collected included demographics, surgical indications, clinical course, and outcomes.

Main Results:

  • Common emergencies: acute cholecystitis (31.5%), strangulated hernia (18.2%), hollow viscus perforation (17.1%), bowel obstruction (10.5%), mesenteric ischaemia (9.4%).

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  • Mortality rate was 14.4% (27/181), with acute mesenteric vascular occlusion being the leading cause of death.
  • Higher mortality observed in mesenteric ischaemia (76.5%), GI bleeding (22.2%), and perforation (19.4%) cases.

    • Conclusions:

    • Acute calculous cholecystitis and strangulated hernias are the most frequent, often preventable, surgical emergencies in the elderly.
    • Prognosis is poor for emergency surgical treatment of acute mesenteric ischaemia, gastrointestinal haemorrhage, and peritonitis in older patients.