Abdominal emergencies in the geriatric patient

Spangler, Ryan; Pham, Thuy Van; Khodjah, Danya; Martinez, Joseph P.

doi:10.1186/preaccept-3303381914150346

Cited by 17 publications

(30 citation statements)

References 17 publications

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“…Causes of small intestinal obstruction differ between young and older patients. Typically, younger [20]. It should be noted that these causes are preventable by regular colonoscopic screening and elective hernia surgery.…”

Section: Discussionmentioning

confidence: 99%

Indications for Emergency Abdominal Surgeries in Older Patients: 7-Year Experience of a Single Centre

et al. 2020

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The majority of patients undergoing emergency laparotomy are older adults that carry the highest mortality. More research into the development of targeted interventions is required. Therefore, the aim of the study was to analyse the indications for emergency abdominal surgery in patients aged ≥ 65 admitted to the Department of General Surgery. The study included consecutive patients aged ≥ 65 who underwent emergency abdominal surgery within 48 h after admission at one institution. In 2010-2017, 986 patients were enrolled in the study (female 57%, male 43%). Patients were divided into three age groups, 65-70, 71-84 and ≥ 85, with 255 patients (25.9%), 562 patients (57.0%) and 169 patients (17.1%) in each group, respectively. In the first and second age groups, the most common indications for surgery were acute cholecystitis, non-malignant ileus, colorectal cancer complications and acute appendicitis. In the oldest patients, the most common indications were complications of colorectal cancer, acute cholecystitis, nonmalignant ileus and complications of diverticulosis. In the women, the biggest differences in indications between age groups were colorectal cancer (p = 0.025) and peptic ulcer disease complications (p = 0.005); in the men, the biggest difference was seen for complicated diverticulitis (p = 0.001). The most frequent comorbidities were heart diseases (81.0%), followed by endocrine (33.6%) and vascular diseases (22.7%). The three most common indications for emergency surgery in older patients at our institution were acute cholecystitis, colorectal cancer complications and non-malignant bowel obstruction, affecting 59.5% of this group of patients. Elective surgery and endoscopic screening have the potential to prevent major part of these acute diseases. However, further prospective research is necessary on this field, particularly among frail, older patients.

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Section: Discussionmentioning

confidence: 99%

Indications for Emergency Abdominal Surgeries in Older Patients: 7-Year Experience of a Single Centre

et al. 2020

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“…In acute abdominal conditions, some patients will not be able to say that they have abdominal pain, but will have abdominal tenderness or something obvious like a visible hernia. Appendicitis, diverticulitis or cholecystitis can be present without pain or abnormalities on examination Scenario 2 Mr C is an 82‐year‐old man who has been transferred from a residential aged care facility (RACF).…”

Section: Examinationmentioning

confidence: 99%

Older person with vague symptoms in the emergency department: Where should I begin?

Jackman

Laging

et al. 2019

Emerg Medicine Australasia

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Scenario 1Ms J is 81 years old, an active retiree and lives alone. She has been brought to the ED by her daughter feeling tired and flat. She felt well getting up early this morning, but an hour later felt very fatigued, mildly short of breath and nauseated. She returned to bed awaiting her daughter's visit. She has a past history of hypertension, diabetes and hypothyroidism. Her vital signs are normal. The junior ED registrar asks how she should work up this patient?

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“…The change in physiology in elderly leads to atypical presentations, delayed symptoms, less predictable alterations in vital signs in response to disease, and markedly unreliable physical examinations leading to complication of symptom during presentation. 7 Elderly people present in ED with acute abdomen having vascular abnormality (Acute mesenteric ischemia, Abdominal aortic aneurism), intestinal disorder (bowel obstruction, Diverticular disease, Appendicitis), peptic ulcer disease, biliary disease and pancreatitis, and non-abdominal cause of abdominal pain( myocardial infarction, cystitis , pyelonephritis, hyper-calcemic, diabetic ketoacidosis). 8 This study aimed at identifying the frequency, cause and outcome of patient presenting in Emergency department with abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

Status of Geriatric Patients with Abdominal Pain Presented To Emergency Department

Lamsal

Bhandari

2019

J Chitwan Med Coll

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Background: As the development of better health facilities with advanced tools for diagnosis and management our country is not away from global trend. Nepal’s life expectancy at birth is increasing at its pace, it has increased in about 30 years in last 4 decades. Among the various problem presenting to ED abdominal pain is one of the common complain elderly patients are greater risk of missing life-threatening causes during evaluation and investigation. The aim of the study wasEdit to identify the frequency, cause and outcome of patient presenting in Emergency department with abdominal pain. Methods: It is a retrospective study conducted in tertiary care center at Chitwan, Nepal during the period from 01/09/2017 to 30/08/2018. Electronic data entered by medical officer were retrieved and analyzed. Statistical analysis of the record was done using SPSS 16 software. Results: Elderly population who presented with chief complaints of abdominal pain was 1160 (21.79%). Among the patient presented with abdominal pain 605(52.2%) were male and 555(47.8%) were female. Mean age of patients was 71.72±8.50 years. Most common system involved was gastrointestinal and biliary problem 730(62.93%). Most common diagnosis was Urinary tract infection 269 (23.2%) among them, 487(41.98%) required hospital admission. Conclusions: Abdominal pain is one of the common presentations of elderly to emergency department. Disorders of Gastrointestinal and biliary system were among leading causes of emergency visit. Emergency physician should be tactful to identify life threatening conditions and emergency management.

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Abdominal emergencies in the geriatric patient

Cited by 17 publications

References 17 publications

Indications for Emergency Abdominal Surgeries in Older Patients: 7-Year Experience of a Single Centre

Indications for Emergency Abdominal Surgeries in Older Patients: 7-Year Experience of a Single Centre

Older person with vague symptoms in the emergency department: Where should I begin?

Status of Geriatric Patients with Abdominal Pain Presented To Emergency Department

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