Abdominal pain (geriatrics)

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

• Geriatrics (Main Page)
• Abdominal Pain