International Journal of Gerontology
Volume 1, Issue 2 , Pages 77-82, June 2007

Acute Abdominal Pain in the Elderly

  • Ching-Chih Chang

      Affiliations

    • Taipei Municipal Gan-Dau Hospital, Taiwan
    • ,
  • Sun-Sang Wang

      Affiliations

    • Taipei Municipal Gan-Dau Hospital, Taiwan
    • National Yang-Ming University School of Medicine, Taiwan
    • Division of Gastroenterology, Department of Internal Medicine, Taipei Veterans General Hospital, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Sun-Sang Wang, Taipei Municipal Gan-Dau Hospital, 12, Lane 225, Zhi-Sing Road, Taipei 112, Taiwan

Accepted 10 February 2007.

Article Outline

SUMMARY 

Abdominal pain is a common occurrence in the elderly patients and poses a difficult challenge for the emer-gency physician. Previous studies demonstrated that among the elderly patients presenting to the emergency department with abdominal pain, at least 50% were hospitalized and 30–40% eventually had surgery for the underlying condition. Reasons for the difficult diagnosis of acute abdomen in the elderly are multifactorial, and hence the diagnostic accuracy is lower and the mortality far higher in them than in the younger patients. High suspicion, widely differential diagnosis, and more aggressive use of imaging modalities are critical for these patients. In the geriatric population, biliary tract disease accounts for nearly 25% of cases of acute abdominal pain, followed by nonspecific pain, malignancy, bowel obstruction, complicated peptic ulcer disease, and incarcer-ated hernia. Acute appendicitis, pancreatitis, and diverticulitis are uncommon but important causes of acute abdomen in the elderly. Abdominal vascular diseases, including abdominal aortic aneurysm and mesenteric ischemia, are a rare but lethal condition in acute abdomen. Management of the elderly patients with acute abdomen should focus on keeping the vital signs, adequate hydration, and early administration of analgesics and antibiotics. Consultations with radiologists and surgeons are crucial in the management of difficult cases.

Key Words:  acute abdominal pain , elderly

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PII: S1873-9598(08)70026-7

doi:10.1016/S1873-9598(08)70026-7

International Journal of Gerontology
Volume 1, Issue 2 , Pages 77-82, June 2007

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