Application of Accelerated Rehabilitation Surgery in Gastrointestinal Surgery.

Adding timely rehabilitation surgery is an optimized perioperative measure that can reduce physical stress, reduce surgical risks, and postoperative complications and promote the recovery of organ function. Therefore, it is of great value to study its application in gastrointestinal surgery (GS). To this end, this article applies retrospective analysis and statistical methods to conduct targeted investigations and studies on GS patients. The results of the survey showed that 26.7% of patients were effective in ARS and 40% were effective in treatment. Compared with traditional treatment methods, its effective treatment rate is 13.4% higher.

The acute abdomen in the older person.

The acute abdomen is a common condition in older people. Half of all presentations to hospital require admission, with a third requiring immediate surgery. The Royal College of Surgeons of England have reported a worryingly high mortality rate in the over 80s undergoing emergency surgery, with a 3-fold difference in mortality throughout the England, Wales and Northern Ireland. The aim of this article is to highlight the issues that older people face in relation to acute abdominal pathology.

The CT frequencies of various non-traumatic acute abdominal emergencies in hemodialysis, peritoneal dialysis patients and the general population.

PURPOSE: To investigate the frequency of non-traumatic acute abdominal emergencies in end-stage renal disease (ESRD) (peritoneal dialysis (PD) and haemodialysis (HD)) patients and in the general population as diagnosed by computed tomography (CT) imaging. METHODS: The abdominal CT findings of ESRD patients with non-traumatic acute abdominal pain during the years 2001-2010 have been retrospectively evaluated. Thirty-three HD (14 females, 19 males, mean age: 62 ± 10.5) and 22 PD patients (12 females, 10 males, mean age: 59 ± 9.4) with acute abdominal pathology based on their CT scans have been included into the study. In addition, 127 individuals (68 females, 59 males, mean age: 40.7 ± 12.8) with normal renal functions who presented with non-traumatic acute abdominal pain diagnosed with an acute abdominal pathology based on their CT scans have been prospectively evaluated during the years 2009-2010. RESULTS: While the most frequent etiology in PD patients was peritonitis (45.4%), acute pancreatitis (13.6%) and perforation (18.1), and in HD patients it was nonocclusive mesenteric ischemia (18.1%) and spontaneous intraabdominal bleeding (21.2%). The basic causes of acute abdomen in the general population were ureteral stone (34.6%) and appendicitis (18.1%). CONCLUSIONS: The causes of acute abdominal pain in ESRD patients is significantly different when compared to the general population. And within this special patient population the etiology of acute abdomen differs depending on the renal replacement therapy modality they are receiving. Thus, the causes of acute abdomen in PD patients are mostly peritonitis, acute pancreatitis, and perforation, while being mostly nonocclusive mesenteric ischemia and spontaneous intraabdominal bleeding in patients receiving HD therapy.

[Acute abdomen states in geriatric patients in the intensive care unit complicated by hypovolemic shock]. / Ostre schorzenia jamy brzusznej powiklane wstrzqsem hipowolemicznym u chorych w podeszlym wieku w oddziale intensywnej terapii.

UNLABELLED: Elderly patients suffering from acute pathology and severe medical comorbidities present serious "mix-cases" and their multiple organ deterioration requires intensive care. GOAL OF THE STUDY: analysis of outcome of elderly patients, aged 65 years and over, suffering from acute abdominal surgical pathology associated with hypovolemic shock. MATERIALS AND METHODS: 2 244 patients aged 65 yrs and over were treated with an acute abdomen state in the 2nd Chair and Department of Surgery in Jagiellonian University Hospital within 01.07.1997 and 30.06.2004. 618 patients, aged > 65 yrs underwent surgery because of acute abdominal pathology with hypovolemic shock. Out of this group 239 cases presented peritoneal diffuse inflammation and 104 were diagnosed with bowel obstruction. The principles of the diagnosis and the therapy were common for both groups. The analysis included: mortality rate, duration of hospital and intensive care unit (ICU) stay, continuos assessment based on APACHE II (Acute Physiology And Chronic Health Evaluation) and TISS-28 (Therapeutic Intervention Scoring System) scales, and on modification of MODS (Multiple Organ Dysfuction Score) system. RESULTS: mortality rate patients with peritoneal diffuse inflammation was 51.05%, and was higher than patients with bowel obstruction 48.08%. The difference in these values was caused by infection by pathogenic bacteria of gastrointestinal tract and most frequently by the appearance of multiorgan dysfunction in the group with peritoneal diffuse inflammation, despite lower punctation in the APACHE II and TISS-28 score system.