Acute abdomen in elderly patients

Abstract EN

It has been estimated that 50% of persons who reach the sixth and seventh decades of life will require surgery before they die.

At the time being more elderly people are undergoing surgery and are more likely to be admitted as emergency cases than young, this study was done to evaluate the real situation of this problem in our society & our surgical practice. A prospective study was done on 109 patients (61 male and 48 female) above the age of 60 year, admitted to the emergency unit and surgical wards of Najaf hospitals, complaining from acute abdomen, for one year period Feb.

2004 to Feb.

2005, the study discuss different aspects such as: age, sex distribution, causes, and percentage of operative to conservative management, hospital stay, complications and mortality rate. The mean age was 67.4 years, the largest admission was for age group 60-70(68 %), 81 patients (74.3%) were treated operatively; other 28 patients (25.7%) were treated conservatively.

The most common causes of acute abdomen were intestinal obstruction (30%), liver and gall bladder diseases (24.7%), followed by urinary system disorders (19%), then peptic ulcer (8.25%) , appendicular disorders (7.3%), gynecological diseases (3.6%), pancreatic disorders (3.6%) and other less frequent disorders represent (2.7%).

The most common post-operative complication was chest infection (38.3%), ileus (28.4%), wound infection (19.7%) and thrombophlebitis (16%), mortality rate was (5.5%).

From the present study we concluded that age alone is not contraindication to surgery, and proper management of associated medical illness is mandatory as they may be more important causes of death than the surgical disease itself, mortality may be decreased by avoiding delay of admission and proper timing & decision of surgical intervention.