A Common Surgical Emergency In Elderly: Acute Mechanical Bowel Obstruction

Abstract

Aim: Acute mechanical bowel obstruction (AMBO) is a common surgical emergency. İn geriatric patients, AMBO makes up about 12-15% of emergency cases and 50% of them require urgent oper-ation. The aim of this study is to review the etiological factors, treatment options and the outcome of elderly who had been operated for AMBO. Material and Methods: The files of patients, over the age of 65 and operated due to AMBO be-tween January 2015 and December 2019, have been retrospectively examined. The etiologic factors of AMBO have been reviewed in terms of age, gender, localization of obstruction, previous surger-ies, surgical procedure, histopathologic findings and survival. Results: The mean age of 281 patients with AMBO was 73.4±13,69. 53.3% (n=150) of the patients were male, and 46.7% (n=131) were female. AMSBO cases formed 54.09%, and AMLBO 45.91%. The most common reason for AMBO in females was hernias with 14.9% , while that of males was tumors with 26.6%. Tumors were the most common reason in all AMBO cases with 39.5%. Tumor was the most common mortality reason with 44.4% , followed by hernias with 22.2%. Total mortali-ty rate was 9.6% (n=27). In 66.6% (n=18) of the patients in which mortality was detected, the diag-nosis was AMLBO. Conclusions: The findings of this study supports the current data about etiological factors of AM-BO in elderly with tumors and hernias being the most common; besides the other finding -considering bezoars - that reflect different rates of an endemic area.

Keywords

• bowel obstruction
• elderly
• bezoar

Yaşlılarda Sık Görülen Cerrahi Acil Durum: Akut Mekanik Bağırsak Tıkanıklığı

Abstract

Amaç: Akut mekanik bağırsak tıkanıklığı (AMBT) yaygın bir cerrahi acil durumdur. Geriatrik has-talarda AMBO acil vakaların yaklaşık% 12-15'ini oluşturur ve% 50'si acil operasyon gerektirir. Bu çalışmanın amacı AMBO için ameliyat edilen yaşlıların etiyolojik faktörlerini, tedavi seçeneklerini ve sonuçlarını gözden geçirmektir. Materyal ve metod: Ocak 2015 - Aralık 2019 tarihleri arasında AMBT nedeniyle ameliyat edilen 65 yaş üstü hastaların dosyaları geriye dönük olarak incelendi. AMBT'nin etyolojik faktörleri yaş, cinsiyet, tıkanıklığın lokalizasyonu, önceki ameliyatlar, cerrahi prosedür, histopatolojik bulgular ve sağkalım açısından gözden geçirilmiştir. Sonuçlar: AMBT olan 281 hastanın yaş ortalaması 73.4 ± 13,69 saptandı. Hastaların % 53.3'ü (n = 150) erkek,% 46.7'si (n = 131) kadındı. Akut mekanik ince barsak tıkanıklığı (AMİBT) vakaların % 54.09’nu ve akut mekanik kalın barsak tıkanıklığı (AMKBT) olguların % 45.91’u oluşturmaktaydı . Kadınlarda AMBO'nun en yaygın nedeni % 14.9 ile fıtık iken, erkeklerde% 26.6 ile tümöral neden-lerdi. Tüm AMBT olgularında % 39.5 ile tümörler en sık nedendi. Tümöral nedenler % 44.4 ile en sık mortalite nedeni olarak saptandı. Takiben % 22.2 ile herniler ikinci en sık mortalite nedeni olarak bulundu. Toplam ölüm oranı% 9.6 (n = 27) idi. Mortalite saptanan hastaların % 66.6'sında (n = 18) tanı AMİBT’ idi. Tartışma: Bu çalışmada, literatürle uyumlu olarak yaşlı hasta populasyonunda AMBT’nın en sık görülen nedenleri tümöral nedenler ve fıtıklar olarak saptanmıştır; ancak endemik bölgelerde sık görülen diğer nedenler de - bezoarlar gibi- yaşlı hastalarda AMBT açısından akılda tutulmalıdır.

Keywords

• barsak tıkanıklığı
• yaşlı hasta
• bezoar

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