Abstract
Introduction: Differential diagnosis of acute abdomen ranges from benign to life-threatening causes, necessitating imaging for prompt identification. Elderly individuals tend to postpone seeking medical attention and exhibit atypical pathological manifestations and concurrent illnesses, often requiring more time and resources for evaluation.
Objective: To study, assess, and diagnose causes of acute abdomen accurately and to assess the diagnostic role of CT in cases where clinical examination and ultrasound failed to provide a diagnosis among the elderly.
Methodology: A prospective study at Al-Hussein Teaching Hospital Thi-qar's Emergency Department. Seventy-two patients who were over 60 years old, with inconclusive ultrasound, history, and examinations, were assessed from the 1st of March 2023 to the 1st of March 2024. Patients' demographic and clinical data were collected via a questionnaire. They underwent imaging including X-rays, ultrasound, and CT scans, with contrast used selectively.
Results: A study of 72 elderly patients with non-traumatic acute abdomen revealed males as 58.3%, mean age of 65.23 years. Most resided in urban areas (58.3%), 41.7% were illiterate, and 41.7% were retired. Comorbidities were prevalent (66.7%), primarily diabetes mellitus (44.4%). Tumors were the leading CT diagnosis (29.17%), followed by intestinal obstruction (12.5%). 55.6% required surgery, 44.4% were treated conservatively. Most admissions were to the ward (48.6%), with a mean hospital stay of 3.3 days.
Conclusion: CT imaging aids in diagnosing acute abdominal diseases in the elderly, revealing tumors and obstructions. While valuable, it may not always detect underlying conditions, necessitating comprehensive diagnostic strategies and personalized treatments.