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Acute Abdomen

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Geriatric Trauma and Critical Care
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Abstract

Abdominal pain is a common complaint for geriatric patients presenting for emergency care. Older patients with acute abdominal pain tend to have a higher burden of intra-abdominal disease that is more difficult to diagnose, more frequently requires intervention, and results in worse outcomes than in younger patients. A complete history, careful physical exam, and judicious use of abdominal imaging are mandatory to improve diagnostic accuracy and optimize outcomes.

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References

  1. National Hospital Ambulatory Medical Care Survey: 2008 Emergency Department Summary Tables [Internet]. National Center for Health Statistics and U.S. Census Bureau. 2008.

    Google Scholar 

  2. Kraemer M, Franke C, Ohmann C, Yang Q. Acute appendicitis in late adulthood: incidence, presentation, and outcome. Results of a prospective multicenter acute abdominal pain study and a review of the literature. Langenbecks Arch Surg. 2000;385(7):470–81. PubMed PMID: 11131250.

    Article  CAS  PubMed  Google Scholar 

  3. Cooper GS, Shlaes DM, Salata RA. Intraabdominal infection: differences in presentation and outcome between younger patients and the elderly. Clin Infect Dis. 1994;19(1):146–8. PubMed PMID: 7948517.

    Article  CAS  PubMed  Google Scholar 

  4. Marco CA, Schoenfeld CN, Keyl PM, Menkes ED, Doehring MC. Abdominal pain in geriatric emergency patients: variables associated with adverse outcomes. Acad Emerg Med. 1998;5(12):1163–8. PubMed PMID: 9864129.

    Article  CAS  PubMed  Google Scholar 

  5. Brewer BJ, Golden GT, Hitch DC, Rudolf LE, Wangensteen SL. Abdominal pain. An analysis of 1,000 consecutive cases in a University Hospital emergency room. Am J Surg. 1976;131(2):219–23.

    Article  CAS  PubMed  Google Scholar 

  6. Lewis LM, Banet GA, Blanda M, Hustey FM, Meldon SW, Gerson LW. Etiology and clinical course of abdominal pain in senior patients: a prospective, multicenter study. J Gerontol A Biol Sci Med Sci. 2005;60(8):1071–6. PubMed PMID: 16127115.

    Article  PubMed  Google Scholar 

  7. de Dombal FT. Acute abdominal pain in the elderly. J Clin Gastroenterol. 1994;19(4):331–5. PubMed PMID: 7876517.

    Article  PubMed  Google Scholar 

  8. Rocca WA, Petersen RC, Knopman DS, Hebert LE, Evans DA, Hall KS, et al. Trends in the incidence and prevalence of Alzheimer’s disease, dementia, and cognitive impairment in the United States. Alzheimers Dement. 2011;7(1):80–93. PubMed PMID: 21255746.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Graham JE, Rockwood K, Beattie BL, Eastwood R, Gauthier S, Tuokko H, et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet. 1997;349(9068):1793–6. PubMed PMID: 9269213.

    Article  CAS  PubMed  Google Scholar 

  10. Li-Korotky HS. Age-related hearing loss: quality of care for quality of life. Gerontologist. 2012;52(2):265–71. PubMed PMID: 22383543.

    Article  PubMed  Google Scholar 

  11. Fenyo G. Acute abdominal disease in the elderly: experience from two series in Stockholm. Am J Surg. 1982;143(6):751–4. PubMed PMID: 7091511.

    Article  CAS  PubMed  Google Scholar 

  12. Veehof LJ, Stewart RE, Meyboom-de Jong B, Haaijer-Ruskamp FM. Adverse drug reactions and polypharmacy in the elderly in general practice. Eur J Clin Pharmacol. 1999;55(7):533–6. PubMed PMID: 10501824.

    Article  CAS  PubMed  Google Scholar 

  13. Dang C, Aguilera P, Dang A, Salem L. Acute abdominal pain. Four classifications can guide assessment and management. Geriatrics. 2002;57(3):30–2, 5–6, 41–2. PubMed PMID: 11899547.

    PubMed  Google Scholar 

  14. Potts FE, Vukov LF. Utility of fever and leukocytosis in acute surgical abdomens in octogenarians and beyond. J Gerontol A Biol Sci Med Sci. 1999;54(2):M55–8. PubMed PMID: 10051855.

    Article  PubMed  Google Scholar 

  15. DeCarli C. Mild cognitive impairment: prevalence, prognosis, aetiology, and treatment. Lancet Neurol. 2003;2(1):15–21. PubMed PMID: 12849297.

    Article  PubMed  Google Scholar 

  16. Parker JS, Vukov LF, Wollan PC. Abdominal pain in the elderly: use of temperature and laboratory testing to screen for surgical disease. Fam Med. 1996;28(3):193–7. PubMed PMID: 8900552.

    CAS  PubMed  Google Scholar 

  17. Coodley EL. Laboratory tests in the elderly. What is abnormal? Postgrad Med. 1989;85(1):333–8.

    CAS  PubMed  Google Scholar 

  18. Huber KR, Mostafaie N, Stangl G, Worofka B, Kittl E, Hofmann J, et al. Clinical chemistry reference values for 75-year-old apparently healthy persons. Clin Chem Lab Med. 2006;44(11):1355–60. PubMed PMID: 17087648.

    Article  CAS  PubMed  Google Scholar 

  19. Hale WE, Stewart RB, Marks RG. Haematological and biochemical laboratory values in an ambulatory elderly population: an analysis of the effects of age, sex and drugs. Age Ageing. 1983;12(4):275–84. PubMed PMID: 6660137.

    Article  CAS  PubMed  Google Scholar 

  20. Ahn SH, Mayo-Smith WW, Murphy BL, Reinert SE, Cronan JJ. Acute nontraumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation. Radiology. 2002;225(1):159–64. PubMed PMID: 12355000.

    Article  PubMed  Google Scholar 

  21. Carroll BA. Preferred imaging techniques for the diagnosis of cholecystitis and cholelithiasis. Ann Surg. 1989;210(1):1–12. PubMed PMID: 2662921.

    Article  CAS  PubMed  Google Scholar 

  22. Walsh PF, Crawford D, Crossling FT, Sutherland GR, Negrette JJ, Shand J. The value of immediate ultrasound in acute abdominal conditions: a critical appraisal. Clin Radiol. 1990;42(1):47–9. PubMed PMID: 2202538.

    Article  CAS  PubMed  Google Scholar 

  23. Perret RS, Sloop GD, Borne JA. Common bile duct measurements in an elderly population. J Ultrasound Med. 2000;19(11):727–30, quiz 31. PubMed PMID: 11065260.

    CAS  PubMed  Google Scholar 

  24. Horrow MM, Horrow JC, Niakosari A, Kirby CL, Rosenberg HK. Is age associated with size of adult extrahepatic bile duct: sonographic study. Radiology. 2001;221(2):411–4. PubMed PMID: 11687684.

    Article  CAS  PubMed  Google Scholar 

  25. Barkin AZ, Rosen CL. Ultrasound detection of abdominal aortic aneurysm. Emerg Med Clin North Am. 2004;22(3):675–82. PubMed PMID: 15301845.

    Article  PubMed  Google Scholar 

  26. Taipale P, Tarjanne H, Heinonen UM. The diagnostic value of transvaginal sonography in the diagnosis of endometrial malignancy in women with peri- and postmenopausal bleeding. Acta Obstet Gynecol Scand. 1994;73(10):819–23. PubMed PMID: 7817736.

    Article  CAS  PubMed  Google Scholar 

  27. Fleischer AC, Rogers WH, Rao BK, Kepple DM, Jones HW. Transvaginal color Doppler sonography of ovarian masses with pathological correlation. Ultrasound Obstet Gynecol. 1991;1(4):275–8. PubMed PMID: 12797059.

    Article  CAS  PubMed  Google Scholar 

  28. Lameris W, van Randen A, van Es HW, van Heesewijk JP, van Ramshorst B, Bouma WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ. 2009;338:b2431. PubMed PMID: 19561056.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Esses D, Birnbaum A, Bijur P, Shah S, Gleyzer A, Gallagher EJ. Ability of CT to alter decision making in elderly patients with acute abdominal pain. Am J Emerg Med. 2004;22(4):270–2. PubMed PMID: 15258866.

    Article  PubMed  Google Scholar 

  30. Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005;172(11):1461–71. PubMed PMID: 15911862.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Stoker J. Magnetic resonance imaging and the acute abdomen. Br J Surg. 2008;95(10):1193–4. PubMed PMID: 18763236.

    Article  CAS  PubMed  Google Scholar 

  32. Costamagna D, Pipitone Federico NS, Erra S, Tribocco M, Poncina F, Botto G, et al. Acute abdomen in the elderly. A peripheral general hospital experience. G Chir. 2009;30(6–7):315–22. PubMed PMID: 19580715.

    CAS  PubMed  Google Scholar 

  33. van Geloven AA, Biesheuvel TH, Luitse JS, Hoitsma HF, Obertop H. Hospital admissions of patients aged over 80 with acute abdominal complaints. Eur J Surg. 2000;166(11):866–71. PubMed PMID: 11097153.

    Article  PubMed  Google Scholar 

  34. Bugliosi TF, Meloy TD, Vukov LF. Acute abdominal pain in the elderly. Ann Emerg Med. 1990;19(12):1383–6. PubMed PMID: 2240749.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to David Spain MD .

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Jou, R.M., Spain, D. (2014). Acute Abdomen. In: Yelon, J., Luchette, F. (eds) Geriatric Trauma and Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8501-8_16

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  • DOI: https://doi.org/10.1007/978-1-4614-8501-8_16

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  • Publisher Name: Springer, New York, NY

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  • Online ISBN: 978-1-4614-8501-8

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