Acute abdomen in the elderly, Hospital de Clínicas, National University of Asunción

Abstract

Acute abdominal pain is a frequent symptom in the elderly and represents 10% of the causes of consultation in emergency medical services; the acute abdomen is of real importance, since it can be the manifestation of complications of pre-existing diseases or of others that present with minimal or no symptoms. The objective was to determine the frequency of acute abdomen, the underlying pathology, symptoms, etiology, complications and evolution. It was an observational, descriptive, retrospective study of patients over 65 years of age who consulted in the Emergency Department of the Hospital de Clínicas for abdominal pain in the period from January 2017 to December 2017. They consulted 2,000 patients for emergencies, of which 330 they were older than 65 years, of which 114 were operated on admission. 204 were men and 126 women. The most common underlying pathologies found were Diabetes Mellitus and Hypertensive Cardiopathy. The evolution time elapsed was on average 181hs (2-360hs). The symptoms were pain, nausea, vomiting and anorexia. The etiology in order of preponderance were biliary pathology 112 patients, upper digestive tract 92 patients, coloproctology 91, parietal disease 30 patients, trauma 5 patients. 114 patients were operated, of which the most frequent cause of laparotomy was biliary, coloproctology and abdominal wall. There were 11.4% (13 cases) of complications, grade IV evisceration in 4 cases, intrahospital pneumonia in 5 cases and infection of the operative wound in 4 cases. The average hospital stay was 26 days (1-51days). Only 9 patients were admitted to the intensive care unit. Obtained 7 cases, the cause was sepsis. It is concluded that the frequency of acute abdomen is 16.5%. Biliary pathology is the most frequent cause of consultation and laparotomy. 11.4% (13 cases) of complications and obituated 6.1% of patients.