M ABDO PAIN

Points and Pearls Excerpt

• Be wary of early diagnostic closure and misdiagnosis of abdominal pain; there are many abdominal and extra-abdominal mimics of dangerous etiologies.
• The elderly, the immunocompromised, women of childbearing age, and patients with prior abdominal surgeries are at a higher risk for misdiagnosis.
• The peritoneum becomes less sensitive with age, and peritonitis can be a late or absent finding.
• Elderly patients can present without fever, leukocytosis, or abdominal tenderness but still have surgical abdominal pathology.
• Consider diagnostic imaging in all geriatric patients presenting with abdominal pain.
• Do not forget the pelvic exam, testicular exam, and rectal exam as part of your physical examination, when appropriate.