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Related Experiment Videos

Small bowel obstruction in the elderly.

B J Zadeh, J M Davis, P C Canizaro

    The American Surgeon
    |August 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Elderly patients with small bowel obstruction (SBO) benefit from prompt surgery, regardless of age. Delayed wound closure significantly reduces infection rates after SBO operations.

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    Area of Science:

    • Gastroenterology
    • Geriatric Surgery
    • Surgical Outcomes

    Background:

    • Small bowel obstruction (SBO) is a common surgical emergency, particularly in the elderly.
    • Accurate preoperative diagnosis of strangulation in SBO remains challenging.
    • Surgical intervention for SBO in elderly patients requires careful consideration of risks and benefits.

    Purpose of the Study:

    • To evaluate the outcomes of surgical and nonoperative management for SBO in patients aged 70 years and older.
    • To assess the reliability of clinical criteria for diagnosing strangulation in elderly SBO patients.
    • To identify factors influencing postoperative complications and mortality in this patient cohort.

    Main Methods:

    • Retrospective review of hospital records for patients aged 70+ treated for SBO between 1975 and 1980.

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  • Analysis of surgical versus nonoperative treatment groups (n=87 vs. n=20).
  • Evaluation of preoperative strangulation criteria, postoperative complications, and mortality rates.

    • Main Results:

    • 35% of patients lacked accepted criteria for strangulation preoperatively.
    • Postoperative complications occurred in 60.9% of surgically treated patients, with wound infection being most common.
    • Delayed primary wound closure reduced infection rates from 21.1% to 6.2% compared to immediate closure.
    • Overall operative mortality was 18%, with advanced carcinoma being a major contributor (60% of fatalities).
    • Mortality was higher in patients with malignant obstruction (40.7%) versus nonmalignant obstruction (10.0%).

    Conclusions:

    • Age alone should not preclude surgical intervention for SBO in the elderly.
    • Malignancy is a significant risk factor for mortality in elderly SBO patients.
    • Delayed primary wound closure is recommended for SBO patients with enterotomies.
    • Prompt surgical intervention for SBO is advised due to unreliable strangulation criteria.