Perforated bowel prognosis elderly
Colorectal cancer screening for older adults
The effect of adjuvant chemotherapy following curative resection in patients with stage II colon cancer is still debated. Since most research did not concentrate on this group, little is known about the effects of adjuvant chemotherapy in patients with stage II colon cancer who are older than 70 years. The aim of this research was to look at the oncologic outcomes of elderly patients with stage II colon cancer who had curative resection with or without adjuvant chemotherapy after surgery. During the years 2002–2015, we checked the medical history of patients over the age of 70 who underwent curative resection of stage II primary colon cancer. Using a logistic regression, patients were divided into two groups: surgery alone (SA) and adjuvant chemotherapy (AC), and their likelihood scores were balanced at a 1:1 ratio. Recurrence-free (RFS), cancer-specific (CSS), and overall survival were the outcomes (OS). After propensity score matching, 145 of the 623 patients who met the criteria were assigned to each limb. The SA and AC groups had mean ages of 74.3 and 74.0 years, respectively. In RFS (p = 0.202), CSS (p = 0.486), and OS (p = 0.299), a log-rank test showed no important inter-group differences. Adjuvant chemotherapy was not found to be an independent factor affecting RFS (p = 0.206), CSS (p = 0.487), or OS (p = 0.301) in a Cox regression study. In elderly patients with stage II colon cancer, adjuvant chemotherapy does not tend to improve survival.
Dr. becker discusses hemorrhagic gastroenteritis
I took an elderly gentleman to the operating room with peritonitis and a benign-looking CT scan during my senior year of residency, only to discover a belly full of black, necrotic intestine. We put him to sleep, told his family, and he died peacefully a few hours later.
One of the attending surgeons asked why this patient had dead bowel when I addressed the case at the Mortality and Morbidity meeting. “You know, Gretchen, sometimes it’s just a way to die,” he said after I rattled off a long list of pathophysiologic possibilities.
Patients also visit the hospital while they are near death. They come in for fear of the unknown and pain, and it’s not unusual for their primary concern to manifest as a surgical issue – a gangrenous toe, a dead gallbladder. As doctors, we sometimes intervene and operate only before they pass away. A close friend from residency called to commiserate about the next paper he was writing, “The Premorbid Gastrectomy: How I Do It,” after a series of bad outcomes. Despite my concerns about gallows humor as a viable coping strategy, the material here is instructive; surgery is not the solution for many elderly or otherwise frail patients.
Bowel obstruction – causes and pathophysiology
Intestinal perforation, described as a split in the bowel wall’s cohesion, is a potentially fatal condition that may occur as a result of a number of diseases. Trauma, instrumentation, inflammation, infection, malignancy, ischemia, and obstruction are all common causes of perforation. Peritonitis and its systemic sequelae caused by the spillage of intestinal contents have a high morbidity and mortality rate, so early diagnosis and care are important. This activity examines the causes and symptoms of intestinal perforation, as well as the interprofessional team’s involvement in its treatment.
Intestinal perforation, described as a split in the bowel wall’s cohesion, is a potentially fatal condition that may occur as a result of a number of diseases. Trauma, instrumentation, inflammation, infection, malignancy, ischemia, and obstruction are all common causes of perforation. Peritonitis and its systemic sequelae caused by the spillage of intestinal contents have a high morbidity and mortality rate, so early diagnosis and care are important. A comprehensive history and physical evaluation, as well as adjunctive research, will assist in quickly establishing the diagnosis and better directing therapy.
Double balloon enteroscopy: small bowel
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Smooth muscle and mucous membranes make up the layers of the colon. The mucosa, or innermost layer, is smooth and pliable, close to the tissues in your mouth. When a hole is formed in the lining of the intestine, it is called a perforation. This may happen as a result of colon surgery or severe bowel disease.
The contents of the colon will then spill into the normally clean contents of your abdominal cavity through a hole in the colon. Perforation of the bowel is a medical emergency that necessitates urgent medical attention.
The contents of your intestine will leak out, causing inflammation, infection, and even abscesses in your abdomen if left untreated. Peritonitis is the medical term for a painful illness that precedes sepsis, or a systemic infection.