How is abdominal pain in the elderly evaluated?

Updated: Jul 17, 2018
  • Author: E David Bryan, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

In the period of time since the last of these studies was published, the availability and accuracy of emergency diagnostic techniques have improved dramatically. Computed tomography and ultrasonography were not widely used in most EDs before the mid 1990s. Today, it is relatively rare for a patient with significant abdominal pain to leave the ED without some type of advanced imaging. Diagnostic accuracy and presumably short-term mortality very likely have improved since the bulk of the studies on this subject were published. In fact, two newer studies showed that CT scanning significantly improved the certainty of diagnosis and altered therapy in elderly patients. [1, 2] Even though imaging has improved diagnostic accuracy, the risk for adverse outcome in this patient population remains high. The only studies published since the widespread use of advanced imaging showed that nearly 60% were hospitalized, and, in the following 2 weeks, 20% underwent surgery and 5% died. [3, 4]


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