Patología quirúrgica abdominal en el paciente de edad avanzada

  1. González Rodríguez, F.J. 1
  2. Paredes Cotoré, J.P. 1
  3. Paz Novo, M. 1
  4. Paulos Gómez, A. 1
  5. Sánchez-Wonenburger, M. 1
  6. Domínguez Comesaña, E. 1
  7. Caínzos Fernández, M.A. 1
  1. 1 Departamento de Cirugía. Servicio de Cirugía General. Complejo Hospitalario Universitario de Santiago de Compostela. Universidad de Santiago de Compostela. Santiago de Compostela. A Coruña, España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2020

Título do exemplar: Enfermedades del aparato digestivo (X)Patología urgente y quirúrgica abdominal

Serie: 13

Número: 10

Páxinas: 551-562

Tipo: Artigo

DOI: 10.1016/J.MED.2020.06.003 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumo

Abdominal surgical pathology in elderly patient is relevant because of two fundamental factors: life expectancy rises and some features of the elderly patients make the diagnosis and treatment a challenge. The prevalence of acute diverticulitis increases with age and usually is located in bowel sigmoid. Diagnosis relies on clinical history and computed tomography (CT). Treatment is conservative (antibiotics), surgery is required only if complications. The diagnosis of acute cholecystitis is based on clinical history and ultrasound; frequently, treatment is surgical with laparoscopic approach. The early diagnosis of acute intestinal ischemia is based on a high level of clinical suspicion and CT angiography is mandatory. Surgical treatment is based on revascularization and non-viable bowel resection. Sigmoid volvulus is the most frequent. Diagnosis is carried out using CT. Initial treatment is endoscopic decompression accompanied by delayed resection of redundant sigma.

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