Based on current knowledge about frail elderly and small bowel obstruction, a flowchart has been developed that offers an approach to diagnosis and treatment of elderly patients with a small bowel obstruction (Fig.
Clin Interv Aging. J Trauma Acute Care Surg. Management and outcomes of small bowel obstruction in older adult patients: a prospective cohort study. 2013;258(1):98–106.Behman R, Nathens AB, Byrne JP, Mason S, Look Hong N, Karanicolas PJ. BMJ. PubMed studies were identified using Mesh terms ‘intestinal obstruction’, ‘small intestine’, ‘ileum’, ‘jejunum’ and ‘aged’ and free text ‘small bowel obstruction’, ‘elderly’, ‘old’, ‘eldest’ and ‘geriatric’. The second patient report of the National Emergency Laparotomy Audit (NELA). It has a bad prognosis in the majority of patients, irrespective of age. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group.
This approach seems uniform for younger and older patients. Hospitalization-associated disability: "she was probably able to ambulate, but I'm not sure". After assessing cognition, frailty and patient goals according to diagnosis, risks and benefits of surgical and conservative management should be weighed. Ann Surg Oncol. 2001;8(8):632–7.Kim YJ, Yoon CJ, Seong NJ, Kang SG, An SW, Woo YN. A prospective randomized trial of transnasal ileus tube vs nasogastric tube for adhesive small bowel obstruction. 2002;39(3):238–47.Song W, Zhang T, Pu J, Shen L, He B. Int J Gynecol Cancer. 2016;103(2):e19–20.Department of Surgery, Radboud University Medical Center, P.O. Small bowel obstruction (SBO) is a common reason for elderly patients to be admitted to hospital under the care of general surgery. Nutrition.
Ann Emerg Med. You can also search for this author in Improving networks between acute care nurses and an aged care assessment team.
You can also search for this author in Ann R Coll Surg Engl. World J Surg. 2016;13(2):118–23.Robinson TN, Wu DS, Pointer L, Dunn CL, Cleveland JC Jr, Moss M. Simple frailty score predicts postoperative complications across surgical specialties. Abdominal emergencies in the geriatric patient. 2007;61(2):290–6.Butler JA, Cameron BL, Morrow M, Kahng K, Tom J. Canadian Journal of Surgery Journal Canadien De Chirurgie. 2016;212(1):138–50.ten Broek RPBKP, Di Saverio S. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. 2013;23(10):2747–53.Wancata LM, Abdelsattar ZM, Suwanabol PA, Campbell DA Jr, Hendren S. Outcomes after surgery for benign and malignant small bowel obstruction. 2014;40(5):674–82.Covinsky KE, Pierluissi E, Johnston CB. Expert and patient consensus on a dynamic model for shared decision-making in frail older patients. Clin Infect Dis.
EO performed the search for relevant literature and wrote the first draft of the manuscript. More importantly, gallstone ileus is responsible for 25% of all non-strangulated small bowel obstructions in the elderly,1and should therefore always be excluded when presented with an elderly patient with a suggestive history. 2016;204(2):428–34.Dunn GP. Int J Clin Pharmacol Ther. Canadian Journal of Surgery Journal Canadien de Chirurgie. Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study. 2003;90(5):542–6.Zhang Y, Gao Y, Ma Q, Dang C, Wei W, De Antoni F, et al. If left untreated the outlook is poor. Outcome of palliative operations for malignant bowel obstruction in patients with peritoneal carcinomatosis from nongynecological cancer. 2015;40(7):2877–82.Millet I, Alili C, Bouic-Pages E, Curros-Doyon F, Nagot N, Taourel P. Journal club: acute abdominal pain in elderly patients: effect of radiologist awareness of clinicobiologic information on CT accuracy.
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