Abdominal surgical emergency in the elderly

gürleyik, günay; GÜRLEYİK, EMİN SAMİ; ÜNALMIŞER, Selçuk

Abdominal surgical emergency in the elderly

MERYEM GÜNAY GÜRLEYİK, (Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Cerrahi Kliniği, İstanbul, Türkiye)

EMİN SAMİ GÜRLEYİK, (Girilmedi)

Selçuk ÜNALMIŞER (Girilmedi)

Turkish Journal of Gastroenterology

2 0

Yıl: 2002 Cilt: 13 Sayı: 1 Sayfa Aralığı: 47 - 52 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Abdominal surgical emergency in the elderly

Öz:

Amaç: Ortalama yaşam süresinin uzamasına bağlı olarak cerrahi girişim gereken yaşlı insan sayısı artmaktadır. Abdominal cerrahi aciller yaşlılar için ciddi ve yaşamı tehdit eden durumlar olabilmektedir. Bu çalışmanın amacı acil cerrahi girişim uygulanan yaşlı olgulardaki sonuçlarımızı bildirmektedir. Yöntem: Acil cerrahi girişim uygulanan 181 yaşlı olgu (60 yaş ve üzeri), demografik özellikleri, acil cerrahi indikasyonlar, postoperatif klinik seyir ve akıbetleri açısından geriye dönük olarak incelendi. Bulgular: Olgularımızın % 61'i erkek ve ortalama yaş 70.3 (60-95) bulundu. Serimizin %19'unu seksen yaş üzerindekiler oluşturdu. Acil ameliyat indikasyonları akut kolesistit (%31.5), inkarsere fıtıklar (%18.2), içi boş organ delinmesi (%17.1), barsak tıkanması (%10.5), akut mezenter iskemi (%9.4), üst gastrointestinal kanama (%5) olarak saptandı. Akut taşlı kolesistitli olguların %45.5'inde safra taşları ultrason ile daha önceden tesbit edilmişti. Fıtık olgularının %93.8'i inkarserasyon öncesi dış karın fıtığı varlığından haberderdi. Erken postoperatif dönemde 27 (%14.4) olgu öldü. Ölen olgularda önde gelen neden mezenterik damar tıkanmasıydı. Mezenter iskemi (%76.5), gastrointestinal kanama (%22.2), ve perforasyonlu (%19.4) olgularda yüksek mortalite gözlendi. Bu üç hastalık gurubuna dahil olgularda ortalam mortalite %36.8 (21/57) iken diğer olgularda %4.8 (6/124) olarak bulundu. Sonuç: Akut taşlı kolesistit ve inkarsere dış fıtıklar yaşlı gurupta sık rastlanan ve önlenebilir cerrahi aciller olarak görüldü. Akut mezenter iskemi, gastrointestinal kanama ve serbest perforasyona bağlı peritonit cerrahi tedavisi prognozunun yaşlı olgularda kötü olduğu sonucuna varıldı.

Anahtar Kelime: Cerrahi işlemler, operatif Yaşlı Yaşlı, 80 ve üzeri Ölüm oranı Karın, akut Hastalık oranı Geriyedönük çalışma

Konular: Cerrahi

Yaşlılardaki abdominal cerrahi aciller

Öz:

Background/aims Longer life expectancy has created an increasing demand for surgical care of the elderly. Abdominal surgical emergencies are potentially serious and life-threatening conditions for this group of patients The aim of this study was to evaluate the records of elderly patients undergoing emergency surgical treatment. Methods: A total of 181 patients aged 60 years and above who had undergone emergency surgical interventions were retrospectively analysed according to demographic features, indications for emergency surgery, post-operative clinical course and outcome. Results: Sixty-one percent of the patients were male, with an average age of 70.3 (range 60-95) years. Octogenarians constituted 19% of our series. Causes of surgical emergency were acute cholecystitis (31.5%), strangulated hernia (18.2%), hollow viscusperforation (17.1%), bowel obstruction (10.5%), acute mesenteric ischemia (9.4%), acute appendicitis (8.3%) and upper gastrointestinal haemorrhage (5%). Gallstones had been previously detected by ultrasound in 25 (45.5%) of 55 patients with acute calculous cholecystitis. Thirty (93.8%) of 32 patients were aware of their external hernias prior to incarceration. Twenty seven patients (14.4%) died in the early postoperative period, with acute mesenteric vascular occlusion being the leading cause of death A higher mortality rate was noted in mesenteric ischaemia (76.5%), gastrointestinal bleeding (22.2%) and in perforation (19.4%) cases, being 36.8% (21/57) in patients with these three severe conditions and 4,8% (6/124) in the remaining patients. Conclusions: Acute calculous cholecystitis and external strangulated hernias, which are generally preventable, were the most common surgical emergencies. Surgical treatment of acute mesenteric ischaemia, gastrointestinal haemorrhage and peritonitis secondary to free perforation had a worse prognosis in older patients.

Anahtar Kelime: Morbidity Retrospective Studies Surgical Procedures, Operative Aged Aged, 80 and over Mortality Abdomen, Acute

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık

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APA	gürleyik g, GÜRLEYİK E, ÜNALMIŞER S (2002). Abdominal surgical emergency in the elderly. , 47 - 52.
Chicago	gürleyik günay,GÜRLEYİK EMİN SAMİ,ÜNALMIŞER Selçuk Abdominal surgical emergency in the elderly. (2002): 47 - 52.
MLA	gürleyik günay,GÜRLEYİK EMİN SAMİ,ÜNALMIŞER Selçuk Abdominal surgical emergency in the elderly. , 2002, ss.47 - 52.
AMA	gürleyik g,GÜRLEYİK E,ÜNALMIŞER S Abdominal surgical emergency in the elderly. . 2002; 47 - 52.
Vancouver	gürleyik g,GÜRLEYİK E,ÜNALMIŞER S Abdominal surgical emergency in the elderly. . 2002; 47 - 52.
IEEE	gürleyik g,GÜRLEYİK E,ÜNALMIŞER S "Abdominal surgical emergency in the elderly." , ss.47 - 52, 2002.
ISNAD	gürleyik, günay vd. "Abdominal surgical emergency in the elderly". (2002), 47-52.

APA	gürleyik g, GÜRLEYİK E, ÜNALMIŞER S (2002). Abdominal surgical emergency in the elderly. Turkish Journal of Gastroenterology, 13(1), 47 - 52.
Chicago	gürleyik günay,GÜRLEYİK EMİN SAMİ,ÜNALMIŞER Selçuk Abdominal surgical emergency in the elderly. Turkish Journal of Gastroenterology 13, no.1 (2002): 47 - 52.
MLA	gürleyik günay,GÜRLEYİK EMİN SAMİ,ÜNALMIŞER Selçuk Abdominal surgical emergency in the elderly. Turkish Journal of Gastroenterology, vol.13, no.1, 2002, ss.47 - 52.
AMA	gürleyik g,GÜRLEYİK E,ÜNALMIŞER S Abdominal surgical emergency in the elderly. Turkish Journal of Gastroenterology. 2002; 13(1): 47 - 52.
Vancouver	gürleyik g,GÜRLEYİK E,ÜNALMIŞER S Abdominal surgical emergency in the elderly. Turkish Journal of Gastroenterology. 2002; 13(1): 47 - 52.
IEEE	gürleyik g,GÜRLEYİK E,ÜNALMIŞER S "Abdominal surgical emergency in the elderly." Turkish Journal of Gastroenterology, 13, ss.47 - 52, 2002.
ISNAD	gürleyik, günay vd. "Abdominal surgical emergency in the elderly". Turkish Journal of Gastroenterology 13/1 (2002), 47-52.