Abdominal Pain Among Older Adults

M. Bachir Tazkarji, MD, CCFP


Geriatrics and Aging. 2008;11(7):410-415. 

In This Article

Diagnostic Studies

Laboratory studies should be ordered for older adults who have acute abdominal pain. Laboratory values are often normal despite the presence of surgical disease. High amylase is nonspecific, and although elevations may indicate pancreatitis, they also may be seen in mesenteric ischemia. Hematuria is commonly seen in individuals who have nephrolithiasis or a urinary tract infection, but it also may be found in cases of appendicitis, diverticulitis, or even ruptured abdominal aortic aneurysm (AAA). An electrocardiogram should be obtained early in the workup of older adults who have abdominal pain.

Plain Radiography. Plain radiography is useful in the evaluation for free intraperitoneal air, signs of obstruction, and the rare case of foreign body ingestion or insertion.

Ultrasonography. The use of ultrasonography may be limited by body habitus, bowel gas, and operator dependence. Ultrasonography is the imaging modality of choice for biliary and pelvic diseases, and it is useful for diagnosing AAA.

Computerized Tomography. Computerized tomography (CT) is highly sensitive for diagnosing perforation, AAA, appendicitis, and other common entities. It is more useful than angiography in cases of suspected mesenteric venous thrombosis; however, angiography is the gold standard.

Angiography. Angiography is the gold standard when acute mesenteric ischemia is highly suspected. Preoperative angiography should be pursued for diagnostic and therapeutic reasons.


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