Role of contrast enhanced computed tomography abdomen in the evaluation of elderly patients presenting to the emergency with acute abdomen- prospective observational study.

Abstract

Background: India's elderly population is rapidly growing, with 149 million people aged 60 years and above in 2022, projected to double to 347 million by 2050. Diagnosing older adults with acute abdomen in the emergency is challenging due to atypical presentations and poorer outcomes. While Contrast Enhanced Computed Tomography (CECT) of the abdomen is the imaging test of choice, administration of radiocontrast agents may prove to be a hurdle. Thus, in this prospective observational study, we assessed the utility of CECT abdomen and pelvis in the evaluation of abdominal pain among geriatric patients presenting to the emergency department.

Results: This study included 100 patients with a median age of 67 years. Although abdomino-pelvic CECT did not lead to a statistically significant change in diagnosis, it did help identify previously missed life-threatening conditions in some patients. The treatment plan was significantly altered following the CECT scan. While there was no statistically significant change in the overall disposition plan before and after the scan, a considerable proportion of patients (~ 73.7%) initially planned for discharge required admission after undergoing CECT.

Conclusion: This study underscores the pivotal role of CECT of the abdomen and pelvis in evaluating geriatric patients presenting to the Emergency Department with acute abdominal symptoms.