COMMON SURGICAL DISEASES IN THE ELDERLY: CLINICAL PRESENTATION, TREATMENT APPROACHES, AND AGE-SPECIFIC FEATURES

Аннотация

В данной статье рассматриваются наиболее распространённые хирургические заболевания у пожилых людей, с акцентом на особенности клинической картины, обусловленные возрастными физиологическими изменениями. Обсуждаются современные методы лечения, адаптированные под потребности гериатрических пациентов, включая предоперационную оценку, периоперационное ведение и послеоперационный уход. Особое внимание уделяется возрастным особенностям, таким как сопутствующие заболевания, замедленное заживление ран и повышенный риск осложнений, с целью улучшения исходов хирургического лечения у пожилых пациентов. Ключевые слова: Пожилые пациенты, хирургические заболевания, клинические особенности, методы лечения, гериатрическая хирургия, возрастные изменения, послеоперационный уход. Introduction: The aging of the global population has become one of the most urgent public health concerns of the 21st century. According to the United Nations, the number of people aged 65 and older will reach over 1.5 billion by 2050. This demographic shift places increasing pressure on healthcare systems, especially in surgical disciplines. In Uzbekistan, the proportion of elderly 108 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference individuals is also steadily increasing, prompting a need for improved clinical and surgical care tailored to the geriatric population. Objective: To examine the most prevalent general surgical diseases among elderly patients, assess their clinical and diagnostic peculiarities, and evaluate modern treatment approaches that account for age-specific physiological and pathological features. Materials and Methods: The study is based on the analysis of data from elderly patients (aged 60 and above) hospitalized for surgical conditions in various general surgery departments. In addition, a review of recent scientific literature, national statistics, and case studies was performed. Diagnostic accuracy, treatment outcomes, and complications were assessed to identify effective management strategies. Results: Elderly patients frequently suffer from a wide spectrum of general surgical diseases, with the most common being: – Acute abdominal conditions: appendicitis, cholecystitis, and perforated peptic ulcers, often presenting with atypical symptoms and delayed diagnoses; – Intestinal obstruction, including both mechanical (e.g., adhesions, tumors) and paralytic forms; – Abdominal malignancies, particularly colorectal and gastric cancers, which are often detected at advanced stages; – Hernias, including incarcerated and recurrent types, which may require urgent surgical intervention; – Soft tissue infections such as phlegmon, necrotizing fasciitis, and pressure ulcers, commonly complicated by diabetes and immobility; – Vascular complications such as deep vein thrombosis (DVT) and pulmonary embolism. In this population, clinical signs are often vague. For example, elderly patients with peritonitis may lack classical symptoms such as abdominal guarding, rebound tenderness, or fever. Cognitive decline and polypharmacy further complicate clinical assessment. Laboratory and instrumental diagnostics (ultrasound, CT, endoscopy) are crucial for early and accurate diagnosis, but their interpretation must consider age-related physiological changes. Comorbidities significantly influence treatment decisions and outcomes. Most elderly patients present with multiple chronic conditions such as hypertension, diabetes mellitus, ischemic heart disease, chronic kidney disease, or chronic obstructive pulmonary disease (COPD), which increase surgical risk. Preoperative assessment using risk stratification tools like ASA (American 109 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference Society of Anesthesiologists) score, Charlson comorbidity index, and frailty scales are recommended. Treatment strategies must be individualized. Whenever possible, minimally invasive or laparoscopic procedures are preferred due to shorter recovery time, reduced pain, and lower complication rates. Enhanced recovery after surgery (ERAS) protocols adapted for geriatric patients have shown promising results in reducing length of hospital stay and postoperative morbidity. Conclusion: General surgical diseases in elderly patients require a distinct clinical and surgical approach. Atypical presentations, increased comorbid burden, and age-related physiological changes complicate both diagnosis and treatment. Timely detection, comprehensive preoperative evaluation, minimally invasive techniques, and a multidisciplinary team approach are critical in improving surgical outcomes in the elderly. Surgeons must collaborate closely with anesthesiologists, geriatricians, cardiologists, and rehabilitation specialists to ensure safe and effective care for this vulnerable group.