Problems and therapeutic strategy for emergency operation of the abdomen in the aged

Abstract

AIM: To study the problems and therapeutic strategies for emergency abdominal operations in elderly patients by comparing aged and non-aged who underwent an emergency operations for abdominal diseases. MATERIALS AND METHODS: The patients were divided into two groups: those 70 years old or more (85 cases, elderly) and those under 70 years old (228 cases, non-elderly). The type of disease, preoperative complications, postoperative course and outcome of main diseases such as ileus and perforation peritonitis were investigated. RESULTS: Regarding emergency diseases in the aged group, ileus, peritonitis and acute appendicitis were frequently found, in that order, and accounted for 79% of the cases. Incarceration of hernia was more frequently found than in the non-elderly group. On the contrary, acute appendicitis was more frequently found in the non-elderly group. Preoperative complications were found in 46 cases (54%), and were most prevalent in hypertension, cardiac diseases, and diabetes mellitus in this order. In the non-elderly group, preoperative complications were found in 59 cases (26%). Postoperative complications were found in 52 cases (61%) in the elderly group and in 21 (9%) in the non-elderly group. Respiratory complications were found most frequently, and were seen in 32% of the elderly cases. Respiratory complications were significantly more frequent in the elderly group than in the non-elderly group. Death following the operation was found in 9% in the aged group which was mostly due to ileus and peritonitis. CONCLUSION: With regard to the acute abdominal diseases in the elderly patients, both diagnosis and indications of surgery for ileus and peritonitis should be adequately done. Preparation for postoperative respiratory complications and cardiovascular diseases might help to save lives of the elderly.