Intestinal Obstruction in the Aged*

Practical Considerations in the Management of the Geriatric Surgical Patient

“…The timing and the type of surgical procedure are of paramount importance, and depend not only on the nature and extent of the disorder necessitating hospitalization, but also on the surgeon's clinical astuteness and judgment. Foldes (62) classifies operations into four groups according to the urgency entailed: (a) true emergency operations such as those for uncontrollable hemorrhage or embolus, (b) early operations, after initial corrective treatment, such as those for acute cholecystitis (63) or intestinal obstruction (64, 65), (c) necessary operations (no emergency) such as those for malignancy, and (d) elective operations, such as those for hernia. Only the last three types are under consideration here.…”

“…There have been reports that the mortality in geriatric emergency operations is two‐ to three‐fold that in the geriatric elective type (66, 67). Contrariwise, it is obvious that temporizing at the wrong instant may be disastrous, and that deficits can be corrected only within the limits of time permitted by the seriousness of the surgical disorder (64, 68, 69).…”