Diagnosis and treatment of acute intestinal obstruction in 151 patients over 80

Abstract

Objective To investigate the diagnosis and treatment of acute intestinal obstruction in aged patients over 80. Methods Data of 151 patients over 80 with acute intestinal obstruction admitted from January 2010 to March 2014 were retrospectively analyzed. Results 136 of 151 cases were mechanical intestinal obstruction, including 95 cases of adhesive ileus, 13 cases of tumorous ileus, 11 cases of bezoar ileus, 4 cases of abdominal internal hernia, 3 cases of intestinal volvulus, 2 cases of incarcerated oblique hernia, 1 cases of duodenal stenosis, 1 case of sigmoid stenosis, 1 case of anastomotic obstruction after radical resection of rectal cancer because of barium, the cause of ileus was unknown in 5 cases. 14 of 151 were dynamic obstruction and 1 of 151 was vascular intestinal obstruction. Conservative treatment was performed in 114 cases and 1 patient died. 30 cases received operation, including 14 cases of enterodialysis, 6 cases of enterostomy, 4 cases of enterotomy, 3 cases of enterectomy, 1 case of right hemicolectomy, 1 case of reduction of volvulus of intestine, 1 case of gastronesteostomy, and 1 patient died. 7 of 151 were against-advice discharged. 12 cases of complications occurred after surgery, including 5 cases of incisional wound infection, 2 cases of heart failure, 1 case of pulmonary infection, 1 case of anastomotic fistula, 1 case of infective shock, 1 case of early postoperative inflammatory bowel obstruction and 1 case of postoperative delirium. Conclusion Adhesive ileus is the most common cause in aged patients over 80 with acute intestinal obstruction. Rational treatment should be carried out according to different conditions. Conservative treatment is often performed and with active perioperative management, most patients will have satisfied results of surgery. Key words: Aged; Intestinal obstruction; Diagnosis; Therapy