Surgical treatment for inflammatory bowel disease in the older patient.
Twenty-six patients who were 60 years of age or older underwent a surgical procedure for inflammatory bowel disease (IBD). Twenty patients had involvement of the colon (14 had ulcerative colitis and six, Crohn's disease). The indications for operation were intractable colitis (eight patients), perforation (three patients), stricture (three patients), toxic megacolon (three patients), anorectal disease (two patients) and carcinoma (one patient). Operations performed were abdominal colectomy (ten patients), segmental colectomy (seven patients), local anorectal procedures (two patients) and total coloprotectomy (one patient). Five patients had a preoperative diagnosis of diverticulitis and two of carcinoma. Among 17 patients who were observed, nine had symptomatic recurrences. In six patients with Crohn's disease of the small intestine, operation was performed for intractability in two patients, perforation in two patients and obstruction, two patients. All underwent resection and primary anastomosis. Four of five patients had recurrences. IBD in the older patient may be confused with other diseases. Recurrence is frequent with limited colonic resection.