Management of acute abdomen in elderly Patients: Challenges and outcomes

Abstract

Acute abdomen represents a critical clinical condition requiring prompt diagnosis and timely intervention to prevent life-threatening complications. In elderly patients, the presentation and management of acute abdomen pose significant challenges due to multiple factors including age-related physiological changes, polypharmacy atypical symptomatology and the presence of multiple comorbidities, These complexities often lead to delayed diagnosis, increased surgical risk, and poorer postoperative outcomes,. This retrospective observational study was conducted to evaluate the patterns of presentation, diagnostic accuracy therapeutic approaches, and short-term outcomes among elderly patients admitted with acute abdomen over a two-year period at a tertiary care hospital. A total of 150 patients aged 65 years or older were included in the analysis, Data on demographic characteristics, presenting symptoms diagnostic modalities used surgical interventions postoperative complications, and mortality rates were collected and analyzed. The most common causes of acute abdomen were found to be acute cholecystitis, bowel obstruction, and perforated peptic ulcer. Computed tomography (CT) scan emerged as the most frequently utilized and accurate imaging modality. However, delayed diagnosis occurred in approximately one-third of cases due to nonspecific symptoms and altered clinical manifestations. The majority of patients underwent surgical intervention, with open procedures being more commonly performed than laparoscopic ones, primarily due to the severity of disease and intraoperative findings, Postoperative complications were observed in nearly half of the patients, including wound infections, pneumonia, myocardial infarction, sepsis, and renal failure. Overall in-hospital mortality was recorded at 12%, emphasizing the high-risk nature of managing acute abdomen in this vulnerable population. This study underscores the importance of early suspicion, appropriate use of diagnostic imaging, preoperative optimization, and a multidisciplinary approach in improving clinical outcomes for elderly patients with acute abdomen. Further research into geriatric-specific protocols and enhanced recovery pathways tailored for elderly surgical patients is warranted.