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Geriatric Trauma and Critical Care pp 35–43Cite as

The Gastrointestinal Tract

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Abstract

The average life expectancy in the United States is 80 years [1]. With advances in healthcare extending the length and quality of our lives, injuries in the geriatric population continue to be increasingly common. This population harbors multiple medical comorbidities and a decreased physiologic reserve, resulting in higher morbidity and mortality rates following acute trauma [2]. Gastrointestinal injury and illness can be especially devastating among the elderly. The following discussion highlights age-related changes in gastrointestinal physiology, the management of gastrointestinal injury, and other common gastrointestinal diseases affecting the elderly.

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Abbreviations

AAST:

American Association for the Surgery of Trauma

ATLS:

Advanced Trauma Life Support

CCK:

Cholecystokinin

CDI:

Clostridium difficile infection

CT scan:

Computed tomography scan

DNA:

Deoxyribonucleic acid

EAST:

Eastern Association for the Surgery of Trauma

ENS:

Enteric nervous system

FAST:

Focused assessment with sonography for trauma

GI:

Gastrointestinal

HSC:

Hematopoietic stem cells

ICU:

Intensive care unit

IDSA:

Infectious Diseases Society of America

LOS:

Length of stay

NK cell:

Natural killer cell

NSAID:

Nonsteroidal anti-inflammatory drug

OIS:

Organ injury scale

SHEA:

Society for Healthcare Epidemiology of America

TLR:

Toll-like receptor

VTE:

Venous thromboembolic event

References

  1. Life expectancy at birth. World Health Organization. 2016. http://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html. Accessed 18 Feb 2016.

  2. Hashmi A, Ibrahim-Zada I, Rhee P, Aziz H, Fain MJ, Friese RS, et al. Predictors of mortality in geriatric trauma patients: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2014;76:894–901.

    Article  PubMed  Google Scholar 

  3. Bitar K, Greenwood-Van Meerveld B, Saad R, Wiley JW. Aging and gastrointestinal neuromuscular function: insights from within and outside the gut. Neurogastroenterol Motil. 2011;23:490–501.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Besanko LK, Burgstad CM, Mountifield R, Andrews JM, Heddle R, Checklin H, et al. Lower esophageal sphincter relaxation is impaired in older patients with dysphagia. World J Gastroenterol. 2011;17:1326–31.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Besanko LK, Burgstad CM, Cock C, Heddle R, Fraser A, Fraser RJ. Changes in esophageal and lower esophageal sphincter motility with healthy aging. J Gastrointestin Liver Dis. 2014;23:243–8.

    PubMed  Google Scholar 

  6. Britton E, McLaughlin JT. Ageing and the gut. Proc Nutr Soc. 2013;72:173–7.

    Article  PubMed  Google Scholar 

  7. Gabella G. Fall in the number of myenteric neurons in aging guinea pigs. Gastroenterology. 1989;96:1487–93.

    Article  CAS  PubMed  Google Scholar 

  8. Gabella G. Development and ageing of intestinal musculature and nerves: the guinea-pig taenia coli. J Neurocytol. 2001;30:733–66.

    Article  CAS  PubMed  Google Scholar 

  9. McDougal JN, Miller MS, Burks TF, Kreulen DL. Age-related changes in colonic function in rats. Am J Phys. 1984;247:G542–6.

    CAS  Google Scholar 

  10. Gomes OA, de Souza RR, Liberti EA. A preliminary investigation of the effects of aging on the nerve cell number in the myenteric ganglia of the human colon. Gerontology. 1997;43:210–7.

    Article  CAS  PubMed  Google Scholar 

  11. Hanani M, Fellig Y, Udassin R, Freund HR. Age-related changes in the morphology of the myenteric plexus of the human colon. Auton Neurosci. 2004;113:71–8.

    Article  PubMed  Google Scholar 

  12. Di Lorenzo C, Flores AF, Hyman PE. Age-related changes in colon motility. J Pediatr. 1995;127:593–6.

    Article  CAS  PubMed  Google Scholar 

  13. Madsen JL, Graff J. Effects of ageing on gastrointestinal motor function. Age Ageing. 2004;33:154–9.

    Article  PubMed  Google Scholar 

  14. Rao SS, Go JT. Update on the management of constipation in the elderly: new treatment options. Clin Interv Aging. 2010;5:163–71.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Goldstein AM, Hofstra RM, Burns AJ. Building a brain in the gut: development of the enteric nervous system. Clin Genet. 2013;83:307–16.

    Article  CAS  PubMed  Google Scholar 

  16. Barlow AJ, Wallace AS, Thapar N, Burns AJ. Critical numbers of neural crest cells are required in the pathways from the neural tube to the foregut to ensure complete enteric nervous system formation. Development. 2008;135:1681–91.

    Article  CAS  PubMed  Google Scholar 

  17. Foong JP, Nguyen TV, Furness JB, Bornstein JC, Young HM. Myenteric neurons of the mouse small intestine undergo significant electrophysiological and morphological changes during postnatal development. J Physiol. 2012;590:2375–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Pasternak A, Szura M, Gil K, Matyja A. Interstitial cells of Cajal (ICC) – systematic review. Folia Morphol (Warsz). 2016; doi:10.5603/FM.a2016.0002.

    Google Scholar 

  19. O’Mahony D, O’Leary P, Quigley EM. Aging and intestinal motility: a review of factors that affect intestinal motility in the aged. Drugs Aging. 2002;19:515–27.

    Article  PubMed  Google Scholar 

  20. Saffrey MJ. Aging of the mammalian gastrointestinal tract: a complex organ system. Age (Dordr). 2014;36:9603.

    Article  Google Scholar 

  21. Saffrey MJ. Cellular changes in the enteric nervous system during ageing. Dev Biol. 2013;382:344–55.

    Article  CAS  PubMed  Google Scholar 

  22. Wiskur B, Greenwood-Van MB. The aging colon: the role of enteric neurodegeneration in constipation. Curr Gastroenterol Rep. 2010;12:507–12.

    Article  PubMed  Google Scholar 

  23. Bernard CE, Gibbons SJ, Gomez-Pinilla PJ, Lurken MS, Schmalz PF, Roeder JL, et al. Effect of age on the enteric nervous system of the human colon. Neurogastroenterol Motil. 2009;21:746–e46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Gomez-Pinilla PJ, Gibbons SJ, Sarr MG, Kendrick ML, Shen KR, Cima RR, et al. Changes in interstitial cells of cajal with age in the human stomach and colon. Neurogastroenterol Motil. 2011;23:36–44.

    Article  CAS  PubMed  Google Scholar 

  25. Bitar KN, Patil SB. Aging and gastrointestinal smooth muscle. Mech Ageing Dev. 2004;125:907–10.

    Article  CAS  PubMed  Google Scholar 

  26. Tarnawski AS, Ahluwalia A, Jones MK. Increased susceptibility of aging gastric mucosa to injury: the mechanisms and clinical implications. World J Gastroenterol. 2014;20:4467–82.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Laine L, Takeuchi K, Tarnawski A. Gastric mucosal defense and cytoprotection: bench to bedside. Gastroenterol. 2008;135:41–60.

    Article  CAS  Google Scholar 

  28. Tarnawski AS, Ahluwalia A, Jones MK. The mechanisms of gastric mucosal injury: focus on microvascular endothelium as a key target. Curr Med Chem. 2012;19:4–15.

    Article  CAS  PubMed  Google Scholar 

  29. Cryer B, Lee E, Feldman M. Factors influencing gastroduodenal mucosal prostaglandin concentrations: roles of smoking and aging. Ann Intern Med. 1992;116:636–40.

    Article  CAS  PubMed  Google Scholar 

  30. Feldman M, Cryer B. Effects of age on gastric alkaline and nonparietal fluid secretion in humans. Gerontology. 1998;44:222–7.

    Article  CAS  PubMed  Google Scholar 

  31. Lee M, Feldman M. Age-related reductions in gastric mucosal prostaglandin levels increase susceptibility to aspirin-induced injury in rats. Gastroenterology. 1994;107:1746–50.

    Article  CAS  PubMed  Google Scholar 

  32. Lee M. Age-related changes in gastric blood flow in rats. Gerontology. 1996;42:289–93.

    Article  CAS  PubMed  Google Scholar 

  33. Gronbech JE, Lacy ER. Role of gastric blood flow in impaired defense and repair of aged rat stomachs. Am J Phys. 1995;269:G737–44.

    CAS  Google Scholar 

  34. Lee M, Feldman M. The aging stomach: implications for NSAID gastropathy. Gut. 1997;41:425–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP. Risk factors for NSAID-associated upper GI clinical events in a long-term prospective study of 34 701 arthritis patients. Aliment Pharmacol Ther. 2010;32:1240–8.

    Article  CAS  PubMed  Google Scholar 

  36. Laine L. Review article: gastrointestinal bleeding with low-dose aspirin – what’s the risk? Aliment Pharmacol Ther. 2006;24:897–908.

    Google Scholar 

  37. van der Flier LG, Clevers H. Stem cells, self-renewal, and differentiation in the intestinal epithelium. Annu Rev Physiol. 2009;71:241–60.

    Article  PubMed  Google Scholar 

  38. Korbling M, Estrov Z, Champlin R. Adult stem cells and tissue repair. Bone Marrow Transplant. 2003;32(Suppl 1):S23–4.

    Article  PubMed  Google Scholar 

  39. Chen J, Astle CM, Harrison DE. Development and aging of primitive hematopoietic stem cells in BALB/cBy mice. Exp Hematol. 1999;27:928–35.

    Article  CAS  PubMed  Google Scholar 

  40. Lee HM, Greeley Jr GH, Englander EW. Effects of aging on expression of genes involved in regulation of proliferation and apoptosis in the colonic epithelium. Mech Ageing Dev. 2000;115:139–55.

    Article  CAS  PubMed  Google Scholar 

  41. O’Sullivan J, Risques RA, Mandelson MT, Chen L, Brentnall TA, Bronner MP, et al. Telomere length in the colon declines with age: a relation to colorectal cancer? Cancer Epidemiol Biomark Prev. 2006;15:573–7.

    Article  Google Scholar 

  42. Zou Y, Sfeir A, Gryaznov SM, Shay JW, Wright WE. Does a sentinel or a subset of short telomeres determine replicative senescence? Mol Biol Cell. 2004;15:3709–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Tierney AJ. Undernutrition and elderly hospital patients: a review. J Adv Nurs. 1996;23:228–36.

    Article  CAS  PubMed  Google Scholar 

  44. Kerstetter JE, Holthausen BA, Fitz PA. Malnutrition in the institutionalized older adult. J Am Diet Assoc. 1992;92:1109–16.

    CAS  PubMed  Google Scholar 

  45. Payette H, Coulombe C, Boutier V, Gray-Donald K. Weight loss and mortality among free-living frail elders: a prospective study. J Gerontol A Biol Sci Med Sci. 1999;54:M440–5.

    Article  CAS  PubMed  Google Scholar 

  46. Boyce JM, Shone GR. Effects of ageing on smell and taste. Postgrad Med J. 2006;82:239–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci. 2001;56 Spec No 2:81–8.

    Google Scholar 

  48. Riepe SP, Goldstein J, Alpers DH. Effect of secreted Bacteroides proteases on human intestinal brush border hydrolases. J Clin Invest. 1980;66:314–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Drozdowski L, Thomson AB. Aging and the intestine. World J Gastroenterol. 2006;12:7578–84.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Feibusch JM, Holt PR. Impaired absorptive capacity for carbohydrate in the aging human. Dig Dis Sci. 1982;27:1095–100.

    Article  CAS  PubMed  Google Scholar 

  51. Salemans JM, Nagengast FM, Tangerman A, van Schaik A, Hopman WP, de Haan AF, et al. Effect of ageing on postprandial conjugated and unconjugated serum bile acid levels in healthy subjects. Eur J Clin Investig. 1993;23:192–8.

    Article  CAS  Google Scholar 

  52. Becker GH, Meyer J, Necheles H. Fat absorption in young and old age. Gastroenterology. 1950;14:80–92.

    CAS  PubMed  Google Scholar 

  53. Pabst R, Russell MW, Brandtzaeg P. Tissue distribution of lymphocytes and plasma cells and the role of the gut. Trends Immunol. 2008;29:206–8; author reply 9–10.

    Google Scholar 

  54. Tlaskalova-Hogenova H, Stepankova R, Kozakova H, Hudcovic T, Vannucci L, Tuckova L, et al. The role of gut microbiota (commensal bacteria) and the mucosal barrier in the pathogenesis of inflammatory and autoimmune diseases and cancer: contribution of germ-free and gnotobiotic animal models of human diseases. Cell Mol Immunol. 2011;8:110–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Shore SA, Cho Y. Obesity and asthma: microbiome-metabolome interactions. Am J Respir Cell Mol Biol. 2016;54(5):609–17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Patterson E, Ryan PM, Cryan JF, Dinan TG, Ross RP, Fitzgerald GF, et al. Gut microbiota, obesity and diabetes. Postgrad Med J. 2016;92(1087):286–300.

    Article  PubMed  Google Scholar 

  57. Bisgaard H, Li N, Bonnelykke K, Chawes BL, Skov T, Paludan-Muller G, et al. Reduced diversity of the intestinal microbiota during infancy is associated with increased risk of allergic disease at school age. J Allergy Clin Immunol. 2011;128:646–52 e1–5.

    Google Scholar 

  58. Bravo JA, Forsythe P, Chew MV, Escaravage E, Savignac HM, Dinan TG, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 2011;108:16050–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Emoto T, Yamashita T, Sasaki N, Hirota Y, Hayashi T, So A, et al. Analysis of gut microbiota in coronary artery disease patients: a possible link between gut microbiota and coronary artery disease. J Atheroscler Thromb. 2016;23(8):908–21.

    Article  CAS  PubMed  Google Scholar 

  60. Rhee SH, Pothoulakis C, Mayer EA. Principles and clinical implications of the brain-gut-enteric microbiota axis. Nat Rev Gastroenterol Hepatol. 2009;6:306–14.

    Article  CAS  PubMed  Google Scholar 

  61. Zhang YJ, Li S, Gan RY, Zhou T, Xu DP, Li HB. Impacts of gut bacteria on human health and diseases. Int J Mol Sci. 2015;16:7493–519.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Makivuokko H, Tiihonen K, Tynkkynen S, Paulin L, Rautonen N. The effect of age and non-steroidal anti-inflammatory drugs on human intestinal microbiota composition. Br J Nutr. 2010;103:227–34.

    Article  PubMed  Google Scholar 

  63. Salminen A, Huuskonen J, Ojala J, Kauppinen A, Kaarniranta K, Suuronen T. Activation of innate immunity system during aging: NF-kB signaling is the molecular culprit of inflamm-aging. Ageing Res Rev. 2008;7:83–105.

    Article  CAS  PubMed  Google Scholar 

  64. Desai A, Grolleau-Julius A, Yung R. Leukocyte function in the aging immune system. J Leukoc Biol. 2010;87:1001–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Ishimoto Y, Tomiyama-Miyaji C, Watanabe H, Yokoyama H, Ebe K, Tsubata S, et al. Age-dependent variation in the proportion and number of intestinal lymphocyte subsets, especially natural killer T cells, double-positive CD4+ CD8+ cells and B220+ T cells, in mice. Immunology. 2004;113:371–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Biswas A, Wilmanski J, Forsman H, Hrncir T, Hao L, Tlaskalova-Hogenova H, et al. Negative regulation of Toll-like receptor signaling plays an essential role in homeostasis of the intestine. Eur J Immunol. 2011;41:182–94.

    Article  CAS  PubMed  Google Scholar 

  67. Shaw AC, Panda A, Joshi SR, Qian F, Allore HG, Montgomery RR. Dysregulation of human Toll-like receptor function in aging. Ageing Res Rev. 2011;10:346–53.

    Article  CAS  PubMed  Google Scholar 

  68. van Duin D, Shaw AC. Toll-like receptors in older adults. J Am Geriatr Soc. 2007;55:1438–44.

    Article  PubMed  Google Scholar 

  69. van Duin D, Mohanty S, Thomas V, Ginter S, Montgomery RR, Fikrig E, et al. Age-associated defect in human TLR-1/2 function. J Immunol. 2007;178:970–5.

    Article  PubMed  Google Scholar 

  70. Holt PR. Gastrointestinal diseases in the elderly. Curr Opin Clin Nutr Metab Care. 2003;6:41–8.

    Article  PubMed  Google Scholar 

  71. Thomson AB. Small intestinal disorders in the elderly. Best Pract Res Clin Gastroenterol. 2009;23:861–74.

    Article  PubMed  Google Scholar 

  72. Tu C, Tsai C, Tsai C, Huang T, Cheng S, Liu T. Postoperative ileus in the elderly. Int J Gerontol. 2014;8:1–5.

    Article  Google Scholar 

  73. Watts DD, Fakhry SM, Group EM-IHVIR. Incidence of hollow viscus injury in blunt trauma: an analysis from 275,557 trauma admissions from the East multi-institutional trial. J Trauma. 2003;54:289–94.

    Article  PubMed  Google Scholar 

  74. Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Champion HR, Gennarelli TA, et al. Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma. 1990;30:1427–9.

    Article  CAS  PubMed  Google Scholar 

  75. Calland JF, Ingraham AM, Martin N, Marshall GT, Schulman CI, Stapleton T, et al. Evaluation and management of geriatric trauma: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73:S345–50.

    Article  PubMed  Google Scholar 

  76. ATLS Student Course Manual. Advanced trauma life support. 9th edn. American College of Surgeons. Chicago, Illinois; 2012.

    Google Scholar 

  77. Nishijima DK, Simel DL, Wisner DH, Holmes JF. Does this adult patient have a blunt intra-abdominal injury? JAMA. 2012;307:1517–27.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Bhagvan S, Turai M, Holden A, Ng A, Civil I. Predicting hollow viscus injury in blunt abdominal trauma with computed tomography. World J Surg. 2013;37:123–6.

    Article  PubMed  Google Scholar 

  79. Ekeh AP, Saxe J, Walusimbi M, Tchorz KM, Woods RJ, Anderson 3rd HL, et al. Diagnosis of blunt intestinal and mesenteric injury in the era of multidetector CT technology – are results better? J Trauma. 2008;65:354–9.

    Article  PubMed  Google Scholar 

  80. Williams MD, Watts D, Fakhry S. Colon injury after blunt abdominal trauma: results of the EAST Multi-Institutional Hollow Viscus Injury Study. J Trauma. 2003;55:906–12.

    Article  PubMed  Google Scholar 

  81. Lawrence DM. Gastrointestinal trauma. Crit Care Nurs Clin North Am. 1993;5:127–40.

    CAS  PubMed  Google Scholar 

  82. Goldberg SR, Anand RJ, Como JJ, Dechert T, Dente C, Luchette FA, et al. Prophylactic antibiotic use in penetrating abdominal trauma: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73:S321–5.

    Article  CAS  PubMed  Google Scholar 

  83. Kirton OC, O’Neill PA, Kestner M, Tortella BJ. Perioperative antibiotic use in high-risk penetrating hollow viscus injury: a prospective randomized, double-blind, placebo-control trial of 24 hours versus 5 days. J Trauma. 2000;49:822–32.

    Article  CAS  PubMed  Google Scholar 

  84. Barbar S, Noventa F, Rossetto V, Ferrari A, Brandolin B, Perlati M, et al. A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism: the Padua Prediction Score. J Thromb Haemost. 2010;8:2450–7.

    Article  CAS  PubMed  Google Scholar 

  85. Zafar SZ, Cornwell EC. Injuries to the small and large bowel. In: Cameron JL, Cameron AM, editors. Current surgical therapy. Philadephia: Elsevier; 2014. p. 1041–5.

    Google Scholar 

  86. Kozar RA, Arbabi S, Stein DM, Shackford SR, Barraco RD, Biffl WL, et al. Injury in the aged: geriatric trauma care at the crossroads. J Trauma Acute Care Surg. 2015;78:1197–209.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Luchette FA. Caring for the geriatric surgical patient. Surg Clin North Am. 2015;95:xvii–xviii.

    Google Scholar 

  88. Livingston EH, Passaro Jr EP. Postoperative ileus. Dig Dis Sci. 1990;35:121–32.

    Article  CAS  PubMed  Google Scholar 

  89. Boeckxstaens GE, de Jonge WJ. Neuroimmune mechanisms in postoperative ileus. Gut. 2009;58:1300–11.

    Article  CAS  PubMed  Google Scholar 

  90. Story SK, Chamberlain RS. A comprehensive review of evidence-based strategies to prevent and treat postoperative ileus. Dig Surg. 2009;26:265–75.

    Article  PubMed  Google Scholar 

  91. Thompson M, Magnuson B. Management of postoperative ileus. Orthopedics. 2012;35:213–7.

    Article  PubMed  Google Scholar 

  92. Brady JT, Dosokey EM, Crawshaw BP, Steele SR, Delaney CP. The use of alvimopan for postoperative ileus in small and large bowel resections. Expert Rev Gastroenterol Hepatol. 2015;9:1351–8.

    Article  PubMed  Google Scholar 

  93. Wolff BG, Michelassi F, Gerkin TM, Techner L, Gabriel K, Du W, et al. Alvimopan, a novel, peripherally acting mu opioid antagonist: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial of major abdominal surgery and postoperative ileus. Ann Surg. 2004;240:728–34; discussion 34–5.

    Google Scholar 

  94. Manger JP, Nelson M, Blanchard S, Helo S, Conaway M, Krupski TL. Alvimopan: a cost-effective tool to decrease cystectomy length of stay. Cent European J Urol. 2014;67:335–41.

    PubMed  PubMed Central  Google Scholar 

  95. Nguyen DL, Maithel S, Nguyen ET, Bechtold ML. Does alvimopan enhance return of bowel function in laparoscopic gastrointestinal surgery? A meta-analysis. Ann Gastroenterol. 2015;28:475–80.

    PubMed  PubMed Central  Google Scholar 

  96. Adam MA, Lee LM, Kim J, Shenoi M, Mallipeddi M, Aziz H, et al. Alvimopan provides additional improvement in outcomes and cost savings in enhanced recovery colorectal surgery. Ann Surg. 2016;264(1):141–6.

    Article  PubMed  Google Scholar 

  97. Nanni G, Garbini A, Luchetti P, Nanni G, Ronconi P, Castagneto M. Ogilvie’s syndrome (acute colonic pseudo-obstruction): review of the literature (October 1948 to March 1980) and report of four additional cases. Dis Colon Rectum. 1982;25:157–66.

    Article  CAS  PubMed  Google Scholar 

  98. Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie’s syndrome). An analysis of 400 cases. Dis Colon Rectum. 1986;29:203–10.

    Article  CAS  PubMed  Google Scholar 

  99. Saunders MD. Acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 2007;17:341–60, vi–vii.

    Google Scholar 

  100. Ponec RJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction. N Engl J Med. 1999;341:137–41.

    Article  CAS  PubMed  Google Scholar 

  101. Elsner JL, Smith JM, Ensor CR. Intravenous neostigmine for postoperative acute colonic pseudo-obstruction. Ann Pharmacother. 2012;46:430–5.

    Article  PubMed  Google Scholar 

  102. American Heart Association. Advanced cardiovascular life support: provider manual. 2011.

    Google Scholar 

  103. Pereira P, Djeudji F, Leduc P, Fanget F, Barth X. Ogilvie’s syndrome-acute colonic pseudo-obstruction. J Visc Surg. 2015;152:99–105.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clinical Instructor in Surgery, University of Cincinnati, Department of Surgery, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267-0558, USA

    Young Kim MD, MS

  2. Divisions of General Surgery and Trauma, Critical Care, and Acute Care Surgery, University of Cincinnati, Department of Surgery, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267-0558, USA

    Timothy A. Pritts MD, PhD, FACS

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  1. Young Kim MD, MS
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Correspondence to Timothy A. Pritts MD, PhD, FACS .

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Editors and Affiliations

  1. Department of Surgery, Stritch School of Medicine Loyola University of Chicago Edward Hines, Jr. Veterans Administration Medical Center, Maywood, Illinois, USA

    Fred A. Luchette

  2. Professor of Surgery, Hofstra School of Medicine Medical Director for Surgical and Perioperative Services, Southside Hospital/Northwell Health, Bay Shore, New York, USA

    Jay A. Yelon

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Kim, Y., Pritts, T.A. (2017). The Gastrointestinal Tract. In: Luchette, F., Yelon, J. (eds) Geriatric Trauma and Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-48687-1_5

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