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Acute ischaemic colitis: outcome in elderly patients
Sergio Leardi1, Fabiola De Vita, Simona Felici
1Geriatric Surgery, Department of Surgical Science, University of L'Aquila, L'Aquila, Italy.
Chirurgia Italiana
|July 19, 2006
Summary
Medical management is effective for elderly patients with ischaemic colitis, showing good outcomes and no mortality. Surgery is reserved for cases with peritonitis, carrying significant risks.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Geriatric Medicine
Background:
- Ischaemic colitis affects elderly patients, requiring specific management strategies.
- Optimal treatment for ischaemic colitis in the elderly remains a clinical challenge.
Purpose of the Study:
- To evaluate the management and long-term outcomes of ischaemic colitis in elderly patients.
- To identify predictors for treatment selection in ischaemic colitis.
Main Methods:
- Retrospective review of 62 elderly patients with ischaemic colitis (1986-2004).
- Analysis of clinical, biohumoral, endoscopic, and X-ray findings.
- Long-term clinical follow-up (mean 8 years) post-treatment.
Main Results:
- Medical therapy (7 days) in 46 patients (74.1%) yielded positive outcomes with no mortality.
- Surgery in 16 patients (25.9%) resulted in high morbidity (62.5%) and mortality (43.7%).
- Absence of bowel sounds, ileus, and air-fluid levels predicted the need for surgery.
Conclusions:
- Medical therapy is the primary treatment for acute ischaemic colitis in the elderly.
- Peritonitis is a key indication for surgical intervention in ischaemic colitis.
- Elderly patients with ischaemic colitis can achieve favorable long-term outcomes with appropriate management.