Aetiological Patterns of Acute Abdomen in different age groups

Abstract

Assessment of the patients at casualty room with severe stomach pain becomes a problem for the physician. Many factors can change the presentation, delaying the accurate diagnosis, with future adverse outcomes. Diagnosis of abdominal pain in elderly are challenging but the lack of obvious clinical findings and different presentations of intra abdominal disorders. Aim of study: To evaluate the differences of acute abdomen in elderly and young patients regarding the clinical presentation, causes and outcome. Patients and methods: Prospective study Conducted inAL- Nassyriah General Hospital in Thi- Qar  from October 2023-October 2024. Seventy two patients who presented with acute abdomen 21 patients of 60 year old & above, (Group B) 51 patients below 60 years. Some of them required laparotomy and all patients were followed up . Male to female ratio in Group A was 1.1:1 & in Group B was 0.76:1. The duration of symptoms was highly significant between both groups, with a higher mean among elderly (56.67±47.12) in comparison with young (18.27±21.77). History of hypertension, diabetes, CVA, IHD and tumors were more commonly & highly significant in elderly. Dehydration was significantly more commonly presented in elderly while tenderness, rigidity and guarding were more commonly presented in younger patients. Urinary system diseases were the most common cause of acute abdomen in elderly patients and the 2nd most common cause of admission was intestinal obstruction. Appendicitis was the most common cause of acute abdomen in young (51%). The post-operative mortality rate was 2.8% of total patients.