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Year : 2020  |  Volume : 33  |  Issue : 2  |  Page : 51-56

Acute abdomen in patients above 60 years

Iraqi Ministry of Health, Al-Yarmouk Teaching Hospital, Baghdad, Iraq

Correspondence Address:
Dr. Ihsan Ali Mohammed
Emergency Department, Al-Yarmouk Teaching Hospital, Baghdad
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IRJCM.IRJCM_1_21

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Background: Acute abdomen is the medical term used for pain in the abdomen that usually comes on suddenly and is so severe that a person may seek emergency treatment; it can signal a variety of more serious conditions, some of which require immediate medical care and or surgery. Aim of the Study: The aim of this study was to evaluate the causes of nontraumatic acute abdomen and their presentation in elderly patients within the Emergency Department at Al-Yarmouk Teaching Hospital and their correlation to the final diagnosis and outcome. Patients and Methods: A descriptive study was conducted on 121 elderly patients aged 60 years and above, complaining of acute abdominal pain (traumatic cases were excluded and unknown patients fate), presented to the emergency unit of Al-Yarmouk Teaching Hospital. The study was done for a period of 13 months (February 1, 2015, till April 1, 2016). The data were collected by interviewing questionnaire, reviewing of records, taking some measurements, and physical examinations. Data were analyzed using the SPSS program version 22. Results: Patients with acute abdomen were included in the present study with a mean age of 68.4 ± 7.5 years with a female-to-male ratio of 2.1:1. The most common chief complaint was pain presented in 100 (59%) of patients, 50 patients (41%) presented with a duration of chief complaint in ≤24 h, 56.2% of the studied patients were hyperthermia, 65% were hypertensive, mean pulse rate of studied patients was 110 ± 12 beat/min, 75.3% of them had tachycardia, mean respiratory rate of studied patients was 19 ± 2/min, and 52% of them had tachypnea. The most common site of pain was right iliac fossa (24.8%), Murphy's sign was positive among 19 patients (16%), tenderness was present in 114 of the patients (94%), abdominal guarding was positive in 106 of the studied patients (88%), jaundice was observed in 27 (22%) patients, dehydration was present among 79 (65%) of studied patients, and 76 of the patients (62.8%) had elevated white blood cell. Cardiovascular diseases were the most common associated diseases (47%). Ultrasound findings of studied acute abdomen patients presented to the emergency department revealed that 26 of them (21.5%) had gallbladder abnormality, 24 (19.8%) had no specific ultrasound findings, and the X-ray finding was abnormal among 44 (36.4%). The most common diagnosis was perforated viscus for 18 (14.8%) patients. More than two-thirds (72; 59.5%) were treated surgically with mortality rate was 18 (14.8%). Conclusion: Pain was the most common complaint among the elderly with acute abdomen, and the right iliac fossa was the common site of pain. Most patients attended the hospital late (after 24 h from starting the symptoms). Perforated viscus and cholecystitis appear to be the main causes of acute abdomen among Iraqi elderly people.

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