Conceptual problems of colon pathologies of surgical interest in the elderly

Case reports of 151 patients above the age of 70 years, treated with colon diseases of surgical interest, have been compared to those of 220 patients treated with similar diagnoses, but in younger ages. The case reports were evaluated on the basis of the available literary data, and interpreted from the points of view of the geriatric pathology. It is concluded that a correct interpretation of surgical pathologies of the colon in the elderly cannot disregard the knowledge of the age-dependent involutive processes concerning particularly this part of the digestive tract, and also other organs and systems in global sense. Aging of the mucosa of colon, after all, represents a more or less expressed reduction of its barrier function against oncogenic factors and pathogenic microorganisms. The degenerative lesions involving continuously the micro- and macrocirculation of the splanchnic regions result in a more frequent occurrence of complications (ischemia, perforations). The instability of the bioimmunological equilibrium and the presence of accompanying diseases complicate further the clinical picture which displays usually a few symptoms even during the evolutive phases of the diseases. Once the diagnosis has been achieved, the therapeutic strategies should be modified individually without giving up the main principles, however, always considering the possible expectations as regards the quality of life of each patients for the remaining life.