Abdominal pain (geriatrics): Difference between revisions

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==Background==
*Elderly pts
**Surgical emergencies are more common in elderly than in any other pt population
**Viral gastroenteritis is uncommon
**Conservative admission strategy is strongly advocated
*Pts with immunosuppression often have delayed or atypical presentations
*Fever is not a reliable marker for surgical disease
==Elderly==
==Elderly==
*60% are surgical
*60% are surgical

Revision as of 23:44, 9 September 2013

Background

  • Elderly pts
    • Surgical emergencies are more common in elderly than in any other pt population
    • Viral gastroenteritis is uncommon
    • Conservative admission strategy is strongly advocated
  • Pts with immunosuppression often have delayed or atypical presentations
  • Fever is not a reliable marker for surgical disease

Elderly

  • 60% are surgical
  • Acute onset assoc w/ catastrophe
  • Med list is important
  • Abd exam generally unhelpful/difficult to localize pain
  • Misc 25%
    • MI, dissection, mesenteric ischemia
  • Biliary Disease - 21%
  • Unknown - 20%
  • Obstruction - 12%
    • prev surg adhesions, internal/external hernia, malignancy
    • sigmoid/cecal volv - persistant pain, can be subacute, n/v, may not have fever
  • Perforated Viscus - 7%
    • nsaids
  • Diverticular - 10%
  • Appendicitis - 5%
    • 60% perforation in OR, lacking rebound/guarding
  • Renal Colic - 4%


See Also