Small bowel obstruction in the elderly: a plea for comprehensive acute geriatric care

World J Emerg Surg. 2018 Oct 20:13:48. doi: 10.1186/s13017-018-0208-z. eCollection 2018.

Abstract

Small bowel obstruction is one of the most frequent emergencies in general surgery, commonly affecting elderly patients. Morbidity and mortality from small bowel obstruction in elderly is high. Significant progress has been made in the diagnosis and management of bowel obstruction in recent years. But little is known whether this progress has benefitted outcomes in elderly patients, particularly those who are frail or have a malignancy as cause of the obstruction, and when considering quality of life and functioning as outcomes. In this review, we discuss the specific challenges and needs of elderly in diagnosis and treatment of small bowel obstruction. We address quality of life aspects and explore how the concept of geriatric assessment can be utilized to improve decision-making and outcomes for elderly patients with a small bowel obstruction.

Keywords: Adhesions; Elderly patients; Quality of life; Small bowel obstruction.

Publication types

  • Review

MeSH terms

  • Clinical Competence / standards
  • Fluid Therapy / methods
  • Geriatrics / methods
  • Geriatrics / standards*
  • Humans
  • Intestinal Obstruction / diagnosis
  • Intestinal Obstruction / therapy*
  • Lower Body Negative Pressure / methods
  • Palliative Care / methods
  • Palliative Care / standards
  • Physical Examination / methods
  • Physical Examination / standards
  • Quality of Life / psychology
  • Tomography, X-Ray Computed / methods
  • Withholding Treatment