[Acute abdominal pain in the elderly].

Abdominal complaints are the leading reason for seeking care in the emergency department (ED) and are estimated to account for 5–10% of all visits1. Abdominal pain is a common occurrence in the elderly patients and poses a difficult challenge for the emergency physician. Since the mean age of the population is increasing, acute abdominal pain in the elderly is becoming more significant and important for the physician. The definition of “elderly” varies among different studies, but most authors define patients older than 65 years as elderly. The term “acute abdomen” may be applied if the onset of pain is sudden and unexpected and if the pain is present for less than 24 hours and associated with other gastrointestinal symptoms. Previous studies demonstrated that among the elderly patients presenting to the ED with abdominal pain, at least 50% were hospitalized and 30–40% eventually had surgery for the underlying condition2,3. Some authors reported that approximately 40% of the elderly patients with acute abdomen were misdiagnosed, contributing to an overall mortality of approximately 10%4. In a report on 1,000 elderly persons admitted to a hospital surgical service, Fenyo5 noted the importance of accurate preliminary ED diagnosis of abdominal complaints when he found a mortality rate of 8% among patients with the correct ED preliminary diagnosis as compared with 19% when the diagnosis was delayed until after admission to the hospital. Therefore, early and correct diagnosis for the elderly patients with acute abdomen is critical and significantly influences the outcome of these patients. Reasons for the difficult diagnosis of acute abdomen in the elderly are multifactorial. ACUTE ABDOMINAL PAIN IN THE ELDERLY