SEKSEN YAÞINDAN BÜYÜK HASTALARDAKÝ ABDOMÝNAL CERRAHÝ ACÝLLER

Seksen yaþ üstündeki hastalarýn sayýsý giderek artmaktadýr. Bu yaþ grubundaki hastalarýn cerrahi özellikleri ise yeterince araþtýrýlmamýþtýr, 1/2/1997-28/2/1999 tarihleri arasýnda Cerrahpaþa Týp Fakültesi Acil Kliniðinde abdominal cerrahi giriþim geçiren hastalarýmýzýn özelliklerini ve mortalite nedenlerini retrospektif olarak inceledik. Toplam 23 hastadan 7si fýtýk, 5'i týkayýcý mezenter damar hastalýðý, 4'ü akut kolesistit, 2'si duodenal ülser delinmesi ve birer hastada mide kanser delinmesi, duodenal ülser kanamasý, sigmoid kolon perforasyonu, akut appendisit, aort anevrizma rüptürü nedeniyle ameliyat edildiler. Dört hasta eþlik eden hastalýklarý nedeniyle kaybedildiler. Fýtýk ve safra taþý hastalýðý gibi uygun koþullarda tedavi edilebilecek olan hastalarýn ve týkayýcý mesenter damar hastalýðýnýn sýklýðý dikkat çekicidir. Yaþ, fýtýk ve safra taþý hastalýðýnda majör kontrendikasyon olarak düþünülmemeli hastalarýn tedavileri geciktirilmemelidir. Akut batýn tablosuyla baþ vuran hastalarda mezenter damar hastalýðýnýn sýklýðý hatýrlanmalýdýr.

ABDOMINAL EMERGENCIES IN OCTOGENERIANS

The number of people over the age of 80 years increases as western population in our country. The objective of this retrospective study was to investigate the features of abdominal emergencies in Octogenarians. Review of the operating room log of Cerrahpaþa Medical School, Emergency department indicated that 23 abdominal emergency operation were performed between February 1997 and February 1999. The median age of the patients was 86 (80-104). The most frequent cause of admission was hernia (30%), and the second most common was occlusive mesenteric vascular disease (21%). Acute cholesystitis constituted third place (17%). There were two cases duodenal ulcer perforation, and one case of bleeding duodenal ulcer, gastric tumor perforation, sigmoid colon perforation, rupture of aortic aneurisma and acute appendicitis. Four patients died in hospital, an overall mortality rate of 17 per cent of operations. Avoidable disease such as hernia and biliary stones should not have been postponed because of age and should be electively treated early before complications develop. Occlusive mesenteric vascular disease was second most common emergency in this study and must be remembered in elderly patients with acute abdomen.