Evaluation of Acute Non-traumatic Abdominal Pain in the Geriatric Population

Authors

• Gabrielle Frumusa, University of LynchburgFollow

Specialty

Emergency Medicine

Advisor

James Kilgore, DMSc, PhD, PA-C, DFAAPA

Abstract

The objective of this paper is to provide a comprehensive review of the emergency department (ED) evaluation of acute non-traumatic abdominal pain in the geriatric population. A comprehensive literature search was conducted using PubMed and Cochrane. The search focused on studies that provided insight into the evaluation of geriatric patients presenting with this chief complaint. This paper synthesizes findings from two meta-analyses, three retrospective analysis studies, one single-center prospective study, and one large systematic review.

Acute non-traumatic abdominal pain in geriatric patients presents a complex and pressing diagnostic challenge for clinicians. This population frequently exhibits atypical, delayed, and nonspecific symptoms. In addition, cognitive impairments and communication barriers can obscure the clinical picture and lead to misdiagnosis or delays in diagnosis. Vital sign abnormalities may also be less pronounced in older adults, which further complicates early recognition of serious conditions. These challenges are concerning given the higher prevalence of life-threatening diagnoses in geriatric patients with abdominal pain, including aortic aneurysm rupture, mesenteric ischemia, and perforated viscus. The mortality rate for elderly patients presenting with abdominal pain in the emergency department approaches 10%, underscoring the critical need for timely and accurate evaluation.

Despite the clinical importance, there is significant variability in how these patients are managed in the ED setting. There remains no universally accepted or standardized diagnostic pathway for assessing acute abdominal pain. Current literature provides valuable insights into diagnostic pitfalls, mortality risk factors, and the utility of imaging modalities such as computed tomography (CT), which has demonstrated high sensitivity in detecting serious pathology. However, the diagnostic approach continues to vary widely across institutions and practitioners, often relying heavily on clinician experience and judgment.

Ultimately, there is a clear need for further research to develop and validate evidence-based, streamlined diagnostic protocols tailored specifically to the geriatric population. More research should be done to systematically review patterns of diagnostic testing nationally. Such advancements would not only enhance early recognition and management of life-threatening conditions but also improve consistency in care and clinical outcomes.

Recommended Citation

Frumusa G. Evaluation of Acute Non-traumatic Abdominal Pain in the Geriatric Population. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).