Abdominal pain (geriatrics)

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 associated with catastrophe
• Med list is important
• Abdominal exam generally unhelpful/difficult to localize pain
• Misc 25%
  • MI, dissection, mesenteric ischemia
• Biliary disease - 21%
• Unknown - 20%
• Obstruction - 12%
  • previous surgery adhesions, internal/external hernia, malignancy
  • sigmoid/cecal volvulus - persistent pain, can be subacute, nausea and vomiting, 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

External Links

• ALiEM: 10 Tips for Approaching Abdominal Pain in the Elderly