The elderly patient presenting with an acute surgical abdomen or bowel obstruction has become a common and challenging situation. These patients bring comorbidity and frailty that necessitate appropriate risk assessment and comprehensive perioperative management. Robust communication is required between patients, families and health professions. The Australia and New Zealand Emergency Laparotomy Audit-Quality Improvement (ANZELA-QI) study is based on the United Kingdom's National Emergency Laparotomy Audit (NELA) and will gather large scale data, providing hospital-level information to enable clinicians to reduce variation in management. Successful management of the elderly laparotomy patient requires close coordination between surgeons, anaesthetists and physicians. The ANZELA-QI study will help establish the role of collaborative models of care and the need for perioperative care teams.
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Eur J Trauma Emerg Surg
January 2025
Division of Acute Care Surgery, Department of Surgery, University of Iowa, Iowa City, IA, USA.
Purpose: Evidence to guide the application of damage control laparotomy (DCL) in emergency surgery patients is limited. We assessed whether DCL use for emergent small bowel or colon surgery increased over time and its impact on outcomes. We hypothesized that DCL would be utilized more often in patients with significant comorbidities or septic shock with improved outcomes.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
North Estonia Medical Centre, Sütiste tee 19, Tallinn, 13419, Estonia.
Purpose: Emergency laparotomy (EL) is a high-risk procedure, especially in frail patients. This study investigates the prevalence of frailty in referral facilities, evaluates the impact of frailty on postoperative morbidity and mortality, and assesses the long-term effect of EL on patients' functional status.
Methods: This prospective multicentre cohort study included patients aged 50 years and older who underwent EL.
Eur J Trauma Emerg Surg
January 2025
Emergency Surgery Research Group Copenhagen (EMERGE), Department og Hepatic and Gastrointestinal Diseases, Copenhagen University Hospital- Herlev and Gentofte, Herlev, 2730, Denmark.
Purpose: Emergency laparotomy can result in a range of physical and neuropsychiatric postoperative complaints, potentially impacting quality of life. This study aimed to assess the effect of emergency laparotomy on health-related quality of life (HRQoL) and how HRQoL influences the risk of readmission.
Method: HRQoL was assessed in patients undergoing emergency laparotomy during a 1-year period.
Jpn J Radiol
January 2025
Department of Radiology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
We report a case of recurrent abdominal bleeding associated with vascular fragility in a 67-year-old woman with neurofibromatosis type 1 (NF-1). Computed tomography (CT) scan revealed hemorrhagic ascites and a pseudoaneurysm of the sigmoid colon artery, which was suspected to be the source of bleeding. Emergency laparotomy confirmed extremely fragile vessels, requiring repeated surgeries for recurrent bleeding.
View Article and Find Full Text PDFSurg Pract Sci
December 2024
The University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, Australia.
Background: Preoperative assessment of risk for emergency laparotomy may enhance decision making with regards to urgency or perioperative critical care admission and promote a more informed consent process for patients. Accordingly, we aimed to assess the performance of risk assessment tools in predicting mortality after emergency laparotomy.
Methods: PubMed, Embase, the Cochrane Library and CINAHL were searched to 12 February 2022 for observational studies reporting expected mortality based on a preoperative risk assessment and actual mortality after emergency laparotomy.
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