ACUTE ABDOMINAL SURGICAL EMERGENCY IN ELDERLY PATIENTS (A PROSPECTIVE STUDY)

Abstract

ABSTRACT Background: Longer life expectancy has created an increasing demand for surgical care of the elderly. In addition, abdominal surgical emergencies are potentially serious and life threatening for this age group of patients. Aim: The aim of this study is to know the type of common surgical abdominal emergencies, mode of treatment, complications and outcome in elderly patients. Patients and methods: One hundred patients aged 60 years and above who had been admitted to the surgical department in Basrah General Hospital were prospectively evaluated according to the demographic features, causes of abdominal emergencies they presented with, post operative clinical course and outcome. Results: Out of 100 patients included in the study 60% were males and 40% were females, with an average age of 67.39 years (range from 60-83 years). The causes of acute surgical abdominal emergencies were intestinal obstruction (55%), hollow viscus perforation (17%), acute cholecystitis (12%), mesenteric vascular occlusion (9%), and acute appendicitis (7%). Most of the cases of intestinal obstruction were due to adhesion, while perforated DU was the main cause of hollow viscus perforation. Twenty patients (20%) died in the early post operative period with mesenteric vascular occlusion being the leading cause of death (35%). Conclusions: Acute intestinal obstruction and hollow viscus perforation appear to be the main causes of acute abdominal surgical emergencies. Obstructed hernia which constituted 14% of the causes is generally preventable. Acute mesenteric ischaemia and bowel obstruction secondary to colonic tumour had a worse prognosis in elderly patients.