Abstract
Abdominal pain can be due to many causes, and the underlying pathology could be due to an infection, mechanical obstruction, biliary disease, malignancy and gastrointestinal ischaemia. The prevalence of acute abdominal pain increases with advancing age. Among the elderly presenting to the emergency department, approximately 50% were hospitalized and 30–40% eventually had surgery. This review provides an overview of acute abdominal pain in the elderly, prevalence, causes and management.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lyon C, Clark DC. Diagnosis of acute abdominal pain in older patients. Am Fam Physician 2006. http://www.aafp.org/afp/2006101/1537html.
e Dombali FT. Acute abdominal pain in elderly. J Clin Gastroenterol 1994;19(4):331–35.
Burg MD, Francis L. Acute abdominal pain in the elderly. Emerg Med. 2005;37(8):8–12.
Bugliosi TF, Meloy TD, Vukor LF. Acute abdominal pain in the elderly. Ann Emerg Med. 1990;19:1383–6.
Rothrock SG, Greenfield RH. Acute abdominal pain in the elderly: clue to identify serious illness. Part 2. Diagnosis and management of common disorders. Emerg Med Rep. 1992;13:195–192.
Bryan D. Abdominal pain in elderly persons. Medscape. http://emedicine.medscape.com/article/776663-overview retreived 6 April, 2014.
Abi-Hanan P, Gleckman R. Acute abdominal pain: a medical emergency in older patients. Geriatrics. 1997;52:72–4.
Kizer KW, Vassar. Emergency department diagnosis of abdominal disorders in the elderly. Am J Emerg Med 1998;16:537–62.
Marco CA, Schroenfeld CN, Kergt PM, Menkes ED, Doehring MC. Abdominal pain in geriatric emergency patients variables associated with adverse outcomes. Acad Emerg Med. 1998;5:1163–8.
Dang C, Aguilera P, Dang A, Salem L. Acute abdominal pain: Four classifications can guide assessment and management. Geriatrics. 2002;57(3):30–2, 35–6, 41–2.
Ross FP, Zarem HA, Morgan AP. Appendicitis in a Community hospital. Arch Surg. 1962;85:1036.
Williams JS, Hale HW. Acute appendicitis in the elderly. Ann Surg. 1965;162:208–212.
Sullivan W. Managing the elderly with abdominal pain. D.O. May 10, 2012. http://www.epn.com/subspecialities/medico-legal/nan:theelderly-withabdominalpain/. Retrieved on 23 December 2013.
Horattas M, Guyton D, Diane W. A reappraisal of appendicitis in the elderly. Am J Surg. 1990;160:291–293.
Kraemer M, Franke C, Ohmann C, Young Q. Acute abdominal pain study group. Acute appendicitis in late adulthood: incidence, prevalence and outcome. Results of a prospective multicenter acute abdominal study and a review of the literature. Langerback Arch Surg. 2000;385:470–8.
Rusnak RA, Borer JH, Fastow JS. Misdiagnosis of acute appendicitis: common features discovered in cases after litigation. Am J Emerg Med. 1994;12397–402.
Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ. Effect of computed tomography of appendix and treatment of patients and use of hospital resources. N Engl J Med. 1998;338:141–6.
Stroman DL, Bayouth CV, Kuhn JA, Westmoreland M, Jones RC, Fisher TL, et al. The role of computed tomography in the diagnosis of acute appendicitis. Am J Surg 1999;178:485–9.
Hui TT, Major KM, Avital I, Hiatt JR, Margulies DR. Outcome of elderly patients with appendicitis. Arch Surg. 2002;37:995–1000.
Morrison DJ, Thompson J, Wilson SE. Acute cholecystitus in the eldely: a surgical emergency. Arch Surg. 1978;113.
Agawal N, Sharma BC, Sarin SL. Endoscopic management of acute cholangitis in elderlypatients. World J Gastroenterol 12 (40):6551–6555. Publication. https://doi.org/10.3748/wjg:r12140.6551.
van Lent AU, Bartelsman JF, Tylgol GN, Speelman P, Prins JM. Duration of antibiotic therapy for cholangitis after successful endoscopic drainage of the biliary tract. Gastroenterol Endosc. 2002;55:518–522.
Sugiyama M, Atomi Y. treatment of acte cholangitis due to choledocholithiasis in elderly and younger patients. Arch Surg. 1997;132:1129–1133.
Pitt A, Cameron JL, Postier RG, Gadacz TR. Factors affecting mortality in biliary tract surgery. Am J Surg. 1981;142:66–72.
Makela JT, Kiviniemi H, Laitinen S. Acute cholangitis in the elderly. Hepatogastroenterology. 2005; 52:999–1004.
Ng TM, Fock KM, Chia SC, Chew C, Chung Y, Chee E, et al. Peptic ulcer disease in the elderly in Singapore. J Gastroenterol Hepatol. 1994;9:278–81.
Kanna J, Anoop J, Veneet H, Sharm M. Profile of peptic ulcer disease in the elderly. J Gastroenterol Hepatol. 2000;15:H2–H2 (1).
Ng EK, Lam YH, Sung JJ, Yung MY, To KF, Chan AC, et al. Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation.: a randomized controlled trial. Ann Surg. 2000;231(2):153–8.
Warner E, Crighton EJ, Moineddin R, Mamdani M, Ushur R. Fourteen –year study of hospital admissions for diverticular disease in Ontario. Can J Gastroenterol. 2007;21(2):97–9.
Larsson PA. Diverticulitis is increasing in the elderly. Significant cause of morbidity and mortality. Lakaridningen. 1997;94(43):3837–40, 3842.
Collin J. Symptomless abdominal Pain in the elderly. Postgrad Med J. 1989;65:640–641.
Walker JT, Johnson B, Fitz W et al. Abdominal aortic aneurysm in elderly patients. Vasc Endovasc Surg. 1986; 20:79–83.
Robinson D, Mees B, Verhagen H, Cheun J. Aortic aneurysms: Screening, surveillance and referral. Aust Fam Physician 2013;42(6):364–369.
Vigliotti G, D’Alescando A, Fornino G, Puca AE, Capparelli G, Cuofano A, et al. Treatment of aoric aneurysms in elderly patients. BMC Geriatrics. 2011;11(Supp):A66.
Buskins FG. Incidence, risk and operative mortality of abdominal aortic aneurysm in the elderly patient. Tydschr Gerontol Geriatr. 1990;21(4):169–71.
Yasuhara H. Acute mesenteric ischaemia: the challenge of gastroenterology Surg Today. 2005;35(3):185–95.
Ruotolo RA, Evans SR. Mesenteric ischaemia in the elderly. Clin Geriatr Med. 1999;15:527–57.
Huang HH, Chang YC, Yen DH, Kao WF, Chen JD, Wang LM, et al. Clinical factors and outcomes in patients with acute mesenteric ischaemia in the emergency department. J Clin Med Assoc. 2005;68(7):299–306.
Stamatakos M, Stefanaki C, Mastrokalos D, Arampatzi H, Safioleas P, Chatziconstantuiou C, et al. Mesenteric ischaemia: still a deadly puzzle for the medical community. Tohoku J Exp Med. 2008;216(3):197–204.
Lee A, Aldeen AZ. Acute Mesenteric Ischaemia. ACEP News March 2011. http://www.acep.org/Content.aspx?id+80902 retreived on 14 February 2015.
Dewitte A, Biais M, Coquin J, Fleureau CM, Cassinotto C, Onattara A, et al. Diagnosis ans management of acute mesenteric ischaemia. Ann Fr Anesth Reanim. 2011;30(5):410–20.
Avots-Avontins KV, Waugh DE. Colon volvulus and the geriatric patient. Surg Clin North Am. 1982; 62:249–60.
Arenal J, Concelo MP, Benito C, Sanchez J, Garcia-Abril JM, Ortega E. Intestinal obstruction in the elderly. Prognostic factors of mortality. Rev Exp Enferm. Dig. 1999;91(12):838–48.
Abbas S, Bisett CP, Parry BM. Oral water soluble contrast for management of adhesive small bowel obstruction. Cochrane Database Syst Rev. 2007;18(3) CD 004651.
Di Saverio S, Carona F, Ansaloni L, Gavioli M, Valentino M, Pinna AD. Water soluble contrast medium (gastrografin) value in adhesive small intestinal obstruction (ASIO_: a prospective randomised controlled clinical trial). World J Surg. 2008;32(10):2293–304.
Bender JS, Busuito MJ, Graham C, Allaben RD. Small bowel obstruction in the elderly. Am Surg. 1989;55(6):385–8.
Johnson CD. UK guidelines for the management of acute pancreatitis. Gut. 2005;54:iii1–iii9 https://doi.org/10.1136/gut.2004.057026.
Ross SO, Forsmark CE. Pancreatic and biliary disorders in the elderly. Gastroenterol Clin North Am. 2001;30:531–45.
Espinoza R, Balbontin P, Feuerhake S, Senera C. Acute abdomen in the elderly. Rev Med Chil. 2004;132(12):21505–12.
Feldt KS, Ryden G, Miles S. Treatment of pain in cognitively impaired compared with cognitively intact older people with hip fracture. J Am Geriatr Soc. 1998;46:1079–88.
Kauver DR. The geriatric acute abdomen. Clin Gertiatr Med. 1993;9:547–58.
Vogt DP. The acute abdomen in the geriatric patient. Clev Clin J Med 1990;57:125–30.
Potts FE 4th, Vikov LF. Utility of fever and leucocytosis in acute surgical abdomens in octogenarians and beyond. J Gerontol A Biol Sci Med Sci. 1999;54(2):M55–8.
Bates CM, Plevris JN. Clinical evaluation of abdominal pain in adults. Medicine. 2013;41(2):81–86.
Lameris W, van Randen A, van Es HW, van Heesewijk JP, van Ramshorst B, Boum WH, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain.: diagnostic accuracy study. BMJ. 2009;338:624311.
Chiche L, Roupie E, Delassus P. Management of adult abdominal pain in the Emergency Room. J Chir (Paris) 2006;143(1):6–14.
Bryan ED. Abdominal pain in elderly persons. http://emedicine.medscape.com/article/776663-overview accessed 19 January 2017.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this entry
Cite this entry
Nagaratnam, N., Nagaratnam, K., Cheuk, G. (2018). Acute Abdominal Pain in the Elderly. In: Geriatric Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-33434-9_18
Download citation
DOI: https://doi.org/10.1007/978-3-319-33434-9_18
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-33433-2
Online ISBN: 978-3-319-33434-9
eBook Packages: MedicineReference Module Medicine