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Abdominal emergencies in the geriatric patient.

Spangler R, Van Pham T, Khoujah D, Martinez JP - Int J Emerg Med (2014)

Bottom Line: Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED).In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes.We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore 21201, MD, USA.

ABSTRACT
Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities.

No MeSH data available.


Related in: MedlinePlus

CT scan showing an inflamed appendix.
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Figure 5: CT scan showing an inflamed appendix.

Mentions: Despite the advances in modern medicine, appendicitis is still misdiagnosed 54% of the time in the elderly patient population [35]. Half of the patients who are misdiagnosed have bowel perforation by the time of surgery [35]. One-fifth of all elderly patients with appendicitis present after 3 days of symptoms and another 5% to 10% of patients present after 1 week of symptoms [36]. Less than one-third of patients have fever, anorexia, right lower quadrant pain, or leukocytosis. One-quarter of patients have no right lower quadrant pain at all [35],[37],[38]. Though multiple scoring systems have been developed to risk-stratify patients with suspected appendicitis, they have not demonstrated sufficient discriminatory or predictive ability to be used in the elderly population [31]. High clinical suspicion and liberal use of CT scanning in elderly patients is necessary to make this diagnosis in a timely fashion (FigureĀ 5).


Abdominal emergencies in the geriatric patient.

Spangler R, Van Pham T, Khoujah D, Martinez JP - Int J Emerg Med (2014)

CT scan showing an inflamed appendix.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4306086&req=5

Figure 5: CT scan showing an inflamed appendix.
Mentions: Despite the advances in modern medicine, appendicitis is still misdiagnosed 54% of the time in the elderly patient population [35]. Half of the patients who are misdiagnosed have bowel perforation by the time of surgery [35]. One-fifth of all elderly patients with appendicitis present after 3 days of symptoms and another 5% to 10% of patients present after 1 week of symptoms [36]. Less than one-third of patients have fever, anorexia, right lower quadrant pain, or leukocytosis. One-quarter of patients have no right lower quadrant pain at all [35],[37],[38]. Though multiple scoring systems have been developed to risk-stratify patients with suspected appendicitis, they have not demonstrated sufficient discriminatory or predictive ability to be used in the elderly population [31]. High clinical suspicion and liberal use of CT scanning in elderly patients is necessary to make this diagnosis in a timely fashion (FigureĀ 5).

Bottom Line: Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED).In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes.We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Emergency Medicine, University of Maryland School of Medicine, 110 South Paca Street, 6th Floor, Suite 200, Baltimore 21201, MD, USA.

ABSTRACT
Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities.

No MeSH data available.


Related in: MedlinePlus