Abdominal pain (geriatrics): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - " pt " to " patient ") |
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**Viral gastroenteritis is uncommon | **Viral gastroenteritis is uncommon | ||
**Conservative admission strategy is strongly advocated | **Conservative admission strategy is strongly advocated | ||
* | *Patients with immunosuppression often have delayed or atypical presentations | ||
*Fever is not a reliable marker for surgical disease | *Fever is not a reliable marker for surgical disease | ||
Revision as of 08:13, 12 July 2016
Background
- Elderly patients
- Surgical emergencies are more common in elderly than in any other patient population
- Viral gastroenteritis is uncommon
- Conservative admission strategy is strongly advocated
- Patients 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%