Acute abdominal pain in patients over 50 years of age.

This study aimed to discover whether the disease spectrum in elderly patients (50 years and over) differed from that in other ages, and to compare patient presentation, progress and outcome between different age groups. In all, a total of 2406 patients from the OMGE series who were aged 50 and over were studied. Cholecystitis was the commonest disease category, commoner even than NSAP and appendicitis. Obstruction was more than three times as common in the elderly patients. One in four obstruction cases eventually proved to be due to an undiagnosed hernia. Cancer rates rose to 24% in patients over 70; whilst vascular causes accounted for 2.3% of patients over 50. As regards outcome, the risk to life rose steeply after the age of 50, possibly reflecting low rates of diagnostic accuracy. The clinical presentation of appendicitis was quite different in those over 50. Patients over 50 years with acute abdominal pain should be viewed differently from other younger patients, with special care being taken to look for hernia, cancer, and vascular disease. Educational material should also be reviewed to reflect the different features of the elderly patient. It is clear that further data on elderly patients are urgently required.