Gastrointestinal Disorders in Elderly Patients

Reginelli, Alfonso; Pezzullo, Martina; Scaglione, Mariano; Scialpi, Michele; Brunese, Luca; Grassi, Roberto

doi:10.1016/j.rcl.2008.04.013

Cited by 47 publications

(34 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More than 250,000 cases of appendicitis are diagnosed in the United States each year, and appendectomy is the most frequent emergent surgery performed worldwide [1,2]. Despite its prevalence, the diagnosis of appendicitis can be elusive and fraught with pitfalls because of the absence of a pathognomonic sign or symptom, the poor predictive value of associated laboratory testing, and its varied presentation diagnosis [3-5].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature

Pinto

Russo

et al. 2013

Crit Ultrasound J

View full text Add to dashboard Cite

BackgroundUltrasound is a widely used technique in the diagnosis of acute appendicitis; nevertheless, its utilization still remains controversial.MethodsThe accuracy of the Ultrasound technique in the diagnosis of acute appendicitis in the adult patient, as shown in the literature, was searched for.ResultsThe gold standard for the diagnosis of appendicitis still remains pathologic confirmation after appendectomy. In the published literature, graded-compression Ultrasound has shown an extremely variable diagnostic accuracy in the diagnosis of acute appendicitis (sensitivity range from 44% to 100%; specificity range from 47% to 99% ). This is due to many reasons, including lack of operator skill, increased bowel gas content, obesity, anatomic variants, and limitations to explore patients with previuos laparotomies.ConclusionsGraded-compression Ultrasound still remains our first-line method in patients referred with clinically suspected acute appendicitis: nevertheless, due to variable diagnostic accuracy, individual skill is requested not only to perform a successful exam, but also in order to triage those equivocal cases that, subsequently, will have to undergo assessment by means of Computed Tomography.

show abstract

Section: Introductionmentioning

confidence: 99%

Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature

Pinto

Russo

et al. 2013

Crit Ultrasound J

View full text Add to dashboard Cite

show abstract

“…Hematomas, arterial thrombosis or dissection, embolism, pseudoaneurysm formation and bowel infarction are the possible complications of this procedure. Cherian and colleagues shown that, despite an high rate of complications, embolization with microcoils may be more successful than vasopressin infusion [31–34]. …”

Section: Discussionmentioning

confidence: 99%

Bowel Angiodysplasia and Myocardial Infarction secondary to an ischaemic imbalance: a case report

et al. 2015

View full text Add to dashboard Cite

Angiodysplasia, defined as a vascular ectasia or arteriovenous malformation, is the most frequent cause of occult bleeding in patients older than 60 years and a significant association with several cardiac condition is described. Patients with anemia and negative findings on upper endoscopy and colonoscopy should be referred for further investigation of the small bowel. The investigation of choice, when available, is wireless capsule endoscopy. Several therapeutic options are available in this cases, as we reviewed in this report. We report a case of 78-year old man admitted to our Intensive Coronary Unit for dyspnea and chest pain. A diagnosis of non-ST-segment elevation acute coronary syndrome was made and a concomintant, significant anemia was found (hemoglobin 8.2 g/dl).No cororary disease was found by an angiography though the past medical history revealed systemic hypertension, chronic kidney disease (KDOQY stage III), and diabetes mellitus type II on insuline therapy. A Wireless Video capsule examination was positive for jejunum angiodysplasia and an argon plasma coagulation was chosen as terapeutic option. No subsequent supportive therapy and interventions were required in subsequent one year of follow-up.

show abstract

“…Furthermore, clinical presentation may differ significantly in older patients[45]. There are several diseases that should be considered in all older patients with abdominal pain because of the increased incidence and high risk of morbidity and mortality in these patients.…”

Section: Main Bodymentioning

confidence: 99%

The role of US examination in the management of acute abdomen

et al. 2013

View full text Add to dashboard Cite

Acute abdomen is a medical emergency, in which there is sudden and severe pain in abdomen of recent onset with accompanying signs and symptoms that focus on an abdominal involvement. It can represent a wide spectrum of conditions, ranging from a benign and self-limiting disease to a surgical emergency. Nevertheless, only one quarter of patients who have previously been classified with an acute abdomen actually receive surgical treatment, so the clinical dilemma is if the patients need surgical treatment or not and, furthermore, in which cases the surgical option needs to be urgently adopted. Due to this reason a thorough and logical approach to the diagnosis of abdominal pain is necessary. Some Authors assert that the location of pain is a useful starting point and will guide a further evaluation. However some causes are more frequent in the paediatric population (like appendicitis or adenomesenteritis) or are strictly related to the gender (i.e. gynaechologic causes). It is also important to consider special populations such as the elderly or oncologic patients, who may present with atypical symptoms of a disease. These considerations also reflect a different diagnostic approach. Today, surely the integrated imaging, and in particular the use of multidetector Computed Tomography (MDCT) has revolutionised the clinical approach to this condition, simplyfing the diagnosis but burdening the radiologists with the problems related to the clinical management. However although CT emerging as a modality of choice for evaluation of the acute abdomen, ultrasonography (US) remains the primary imaging technique in the majority of cases, especially in young and female patients, when the limitation of the radiation exposure should be mandatory, limiting the use of CT in cases of nondiagnostic US and in all cases where there is a discrepancy between the clinical symptoms and negative imaging at US.

show abstract

Gastrointestinal Disorders in Elderly Patients

Cited by 47 publications

References 52 publications

Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature

Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature

Bowel Angiodysplasia and Myocardial Infarction secondary to an ischaemic imbalance: a case report

The role of US examination in the management of acute abdomen

Contact Info

Product

Resources

About