90歳代超高齢者に対して腹部緊急手術を施行した2例

We report two cases of abdominal emergencies in patients of advanced age over ninety. Case 1 : A 98-year-old woman was referred to our hospital because of abdominal pain. Abdominal CT examination revealed air fluid level and bowel dilatation. Conservative therapy was started with a long decompression tube insertion. However, no symptomatic remission was attained. An emergency laparotomy was performed. At laparotomy, a strangulated intestinal ileus due to an adherent band of omentum was found. The ileus was treated by excision of the band. The patient’s postoperative course was uneventful. Case 2 : A 94-year-old man was referred to our hospital because of abdominal pain. Chest X-ray film showed free air under the right diaphragm. Perforation of digestive tract was suspected and an emergency laparotomy was done. Perforation of a gastric ulcer was found and closure of the hole with omentopexy was done. Postoperative pathohistological examination revealed a gastric cancer. However, the patient and his family rejected operation. The patient was discharged from the hospital５９days postoperatively.