title: Emergency gastrointestinal surgery in the elderly.
abstract: The main problem in management of elderly patients who present to the emergency department with abdominal pain is related to difficulties in establishing a diagnosis, because of frequently impaired communication as well as to unusual clinical and laboratory presentations, resulting in delayed management. Early use of pertinent imaging may reduce this delay. Surgical procedures in the elderly do not differ from those in younger patients, but their associated morbidity is different. Assessing co-morbidities and patient frailty, as well as taking into consideration the diagnosis, patients' wishes and status should help in decision-making. Therapeutic decisions should involve surgeons, anesthesiologists and geriatricians alike, both pre- and postoperatively, with the goal of optimizing patients' rehabilitation and offering good and appropriate care while ensuring the humane, social and financial aspects.
authors.affiliation: Service de chirurgie viscérale et digestive, centre hospitalier d'Arcachon, avenue Jean-Hameau, CS 1101, 33164 La Teste-De-Buch cedex, France. Electronic address: marie.savary@ch-arcachon.fr.
authors.forename: M V
authors.initials: MV
authors.lastname: Launay-Savary
authors.affiliation: Pôle de gérontologie clinique, CHU de Bordeaux, hôpital Xavier-Arnozan, 33604 Pessac cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Rainfray
authors.affiliation: Service de chirurgie vasculaire et générale, CHU de Bordeaux, hôpital Pellegrin-Tripode, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Dubuisson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D013505:Digestive System Surgical Procedures; D004630:Emergencies; D004636:Emergency Service, Hospital; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D011379:Prognosis
keywords: Abdominal surgery; Elderly; Emergency