Abdominal emergencies in the geriatric patient

Ryan Spangler, Thuy Van Pham, Danya Khoujah, Joseph P Martinez, Ryan Spangler, Thuy Van Pham, Danya Khoujah, Joseph P Martinez

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.

Keywords: Abdominal aortic aneurysm; Abdominal pain; Appendicitis; Elderly; Mesenteric ischemia.

Figures

Figure 1
Figure 1
CT angiogram demonstrating stenosis of the superior mesenteric artery.
Figure 2
Figure 2
Ultrasound image diagnostic for abdominal aortic aneurysm.
Figure 3
Figure 3
Left lateral decubitus radiograph demonstrating air-fluid levels. Incidental surgical clips from prior bowel resection are also noted.
Figure 4
Figure 4
Radiograph demonstrating sigmoid volvulus.
Figure 5
Figure 5
CT scan showing an inflamed appendix.
Figure 6
Figure 6
Upright chest film showing free air under the diaphragm.
Figure 7
Figure 7
Ultrasound of a patient with acute cholecystitis. A very large gallstone with significant surrounding edema can be seen.
Figure 8
Figure 8
Upright abdominal radiograph demonstrating an air-fluid level in the gallbladder, diagnostic for emphysematous cholecystitis.

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Source: PubMed

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