Overview
How common is abdominal pain in elderly persons?
How is abdominal pain in the elderly evaluated?
Which factors increase the difficulty of correctly diagnosing abdominal pain in elderly persons?
What is the mortality rate for abdominal pain in elderly persons?
How common is abdominal pain in elderly persons caused by appendicitis?
What is the role of peptic ulcer disease in abdominal pain in elderly persons?
What is the pathophysiology of abdominal pain in elderly persons?
What is the role of biliary tract disease in abdominal pain in the elderly?
What is the pathophysiology of diverticulitis-caused abdominal pain in elderly persons?
What are the signs and symptoms of mesenteric ischemia-caused abdominal pain in elderly persons?
What is the role of bowel obstruction in abdominal pain in elderly persons?
How is an abdominal aortic aneurysm cause of abdominal pain in the elderly diagnosed?
What is the prevalence of a malignancy etiology of abdominal pain in elderly persons?
What is the role of gastroenteritis in abdominal pain in elderly persons?
What are the signs and symptoms of MI or pneumonia-caused abdominal pain in elderly persons?
What are causes of abdominal pain in elderly persons?
What frequently is bowel obstruction the cause of abdominal pain in elderly persons?
What are the racial predilections of abdominal pain in elderly persons?
How does age affect the incidence of abdominal pain in elderly persons?
Presentation
What are the challenges to obtaining a patient history for abdominal pain in elderly persons?
What is the focus of clinical history in the evaluation of abdominal pain in elderly persons?
What are the associated symptoms of abdominal pain in elderly persons?
Which medical history findings help determine the etiology of abdominal pain in elderly persons?
What is the significance of vital signs in the evaluation of elderly persons with abdominal pain?
Which abdominal findings are significant in the evaluation of an elderly person with abdominal pain?
DDX
What are important considerations in the diagnosis of abdominal pain in elderly persons?
What are the differential diagnoses for Abdominal Pain in Elderly Persons?
Workup
What is the role of complete blood count (CBC) in the workup of abdominal pain in elderly persons?
What is the role of serum chemistries in the workup of abdominal pain in elderly persons?
What is the role of serum lipase or amylase in the workup of abdominal pain in elderly persons?
What is the role of urinalysis in the workup of abdominal pain in elderly persons?
What is the role of blood cultures in the workup of abdominal pain in elderly persons?
What is the role of arterial blood gases in the workup of abdominal pain in elderly persons?
What is the role of serum lactate in the workup of abdominal pain in elderly persons?
When is blood type and crossmatch indicated for the workup of abdominal pain in elderly persons?
What is the role of imaging studies in the workup of abdominal pain in elderly persons?
What is the role of abdominal radiography in the workup of abdominal pain in elderly persons?
What is the role of chest radiography in the workup of abdominal pain in elderly persons?
What is the role of abdominal ultrasonography in the workup of abdominal pain in elderly persons?
What is the role of CT scanning in the workup of abdominal pain in elderly persons?
What are significant CT findings in the diagnosis of abdominal pain in elderly persons?
What is the role of angiography in the workup of abdominal pain in elderly persons?
What is the role of ECG in the workup of abdominal pain in elderly persons?
Treatment
What is included in prehospital care for abdominal pain in elderly persons?
What is the initial emergency department (ED) care for abdominal pain in elderly persons?
What is included in emergency department (ED) care of abdominal pain in elderly persons?
What is the role of medications in the ED treatment of abdominal pain in elderly persons?
When is inpatient admission indicated for the treatment of abdominal pain in elderly persons?
What are indications for patient discharge elderly persons with abdominal pain?
Which specialist consultations are beneficial to elderly patients with abdominal pain?
Medications
What are the goals of drug treatment for abdominal pain in elderly persons?
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Inflammatory mass in the right lower quadrant of an 84-year-old woman with mild abdominal pain of 2 days' duration. A ruptured appendix was found at surgery.
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CT scan of a 76-year-old woman with severe abdominal pain of 3 hours' duration. Note the ringlike enhancement of bowel wall in the posterior abdomen. Ischemic small bowel was resected at surgery.
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Radiograph of a 90-year-old man with abdominal pain of 4 days' duration. Plain films reveal large bowel dilatation. Sigmoid volvulus with ischemic colon was diagnosed at surgery.
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Radiograph of a 79-year-old woman with several hours of diffuse abdominal pain. Initial examination of the plain films suggests bowel obstruction.
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Radiograph of a 79-year-old woman with several hours of diffuse abdominal pain. Initial examination of the plain films suggests bowel obstruction. Close-up view reveals pneumatosis intestinalis, indicating mesenteric ischemia.
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CT scan of a 64-year-old woman with vague abdominal pain of 2 days' duration. Physical examination revealed a tender palpable mass in the left lower quadrant. CT scan reveals an incarcerated ventral hernia.
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CT scan of a 62-year-old man who reported 2 weeks of left lower quadrant abdominal pain. CT scan reveals fat stranding and multiple diverticula around the descending colon. A phlegmon containing bowel and inflammatory tissue has eroded into the left psoas muscle.
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A lower CT scan slice from a 62-year-old man who reported 2 weeks of left lower quadrant abdominal pain. Multiple diverticula are observed with an inflammatory mass overlying the left ilium.