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The Surgical Abdomen

  • Carlos A. Pelaez
  • Nanakram Agarwal
Chapter

Abstract

Abdominal pain is a common and challenging problem in the geriatric population, characterized by abrupt severe pain that requires an urgent and specific diagnosis. A rapidly worsening prognosis may occur in absence of prompt intervention. The most common causes of acute abdomen in the older age group are cholecystitis, appendicitis, perforated peptic ulcer disease, pancreatitis, intestinal obstruction, ischemic bowel disease, diverticulitis, and obstructed hernias. Symptoms and physical findings are unreliable in the elderly, contributing to misdiagnosis in approximately 40% of the patients. Inordinate delays of initial assessment, diagnosis, and treatment contribute to significantly increased mortality. Upright chest X-ray initially to exclude free intraperitoneal air, followed by CT, has the highest yield. Older adults have acceptable survival rates after major abdominal surgery, but tolerate complications poorly. Early diagnosis, aggressive resuscitation, and prompt surgical intervention tailored to the physiologic status improve survival in the geriatric patient.

Keywords

Small Bowel Obstruction Common Bile Duct Stone Biliary Tract Disease Perforated Peptic Ulcer Laparoscopic Common Bile Duct Exploration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Carlos A. Pelaez
    • 1
  • Nanakram Agarwal
    • 1
  1. 1.Department of SurgeryMontefiore Medical Center (North Division)BronxUSA

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