Article Sidebar

Submitted
April 1, 2026
Accepted
June 10, 2026
Published
June 12, 2026
Download
PDF
Statistic
Read Counter : 37

Main Article Content

Abstract

Background: Acute abdominal pain is a common emergency presentation. Clinical features, aetiology, and outcomes differ markedly between young and elderly patients.


Objectives: To compare presentation, diagnosis, management, and outcomes of acute abdominal pain between young (<60 years) and elderly (≥60 years) patients.


Patients and Methods: A prospective study of 193 patients at Al-Hussain Teaching Hospital, Nasiriyah, Iraq (January–November 2024). Group A: young (<60 years, n=139); Group B: elderly (≥60 years, n=54).


Results: Acute appendicitis predominated in young patients (51.80% vs. 16.67%, p<0.001). Perforated duodenal ulcer (27.78% vs. 7.19%, p=0.018) and intestinal obstruction (24.07% vs. 4.32%, p<0.001) were more frequent in the elderly. Young patients more often had tenderness, right iliac fossa pain, and rigid abdomen, while constipation and distension were commoner in elderly patients. Appendectomy was performed more in young patients (51.80% vs. 11.11%, p<0.001); conservative management predominated in the elderly (72.22% vs. 33.09%, p<0.001). UTI complications were significantly higher in elderly patients (9.26% vs. 0.72%, p=0.012).


Conclusions: Elderly patients present atypically with higher rates of serious pathology and postoperative complications. Age-stratified protocols are essential to optimize outcomes.

Keywords

acute abdominal pain elderly appendicitis intestinal obstruction perforated duodenal ulcer emergency surgery age comparison

Article Details

License

Copyright (c) 2026 Hayder Hasan Hadi, Abdulhadi Jabbar Sarhan (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite
Hayder Hasan Hadi and Abdulhadi Jabbar Sarhan (2026) “Acute Abdominal Pain in Young Versus Elderly Patients: A Comparative Prospective Study of Clinical Presentation, Aetiology, and Management Outcomes”, Journal of Biomedicine and Biochemistry, 5(2), pp. 62–69. doi:10.57238/jbb.2026.7432.1172.
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

How to Cite

Hayder Hasan Hadi and Abdulhadi Jabbar Sarhan (2026) “Acute Abdominal Pain in Young Versus Elderly Patients: A Comparative Prospective Study of Clinical Presentation, Aetiology, and Management Outcomes”, Journal of Biomedicine and Biochemistry, 5(2), pp. 62–69. doi:10.57238/jbb.2026.7432.1172.
Crossref
Scopus
Google Scholar
Europe PMC

References

  1. Gill BD, Jones JJ. Cost-effective evaluation and management of the acute abdomen. Surg Clin North Am. 1996;76(1):71–82. https://doi.org/10.1016/s0039-6109(05)70423-0
  2. O'Connell PR, McCaskie AW, Sayers RD, editors. Bailey and Love's Short Practice of Surgery. 28th ed. Boca Raton: CRC Press; 2023. p. 1336–41.
  3. Growdon WB, Laufer MR. Ovarian and fallopian tube torsion. UpToDate [Internet]. [cited 2024 Oct 10]. Available from: https://www.uptodate.com
  4. Pagán Correa KE. Acute abdominal pain in children. J Urgent Care Med. 2013:9–22.
  5. Nagaratnam N, Nagaratnam K, Cheuk G. Acute abdominal pain in the elderly. In: Geriatric Diseases. Cham: Springer; 2017. https://doi.org/10.1007/978-3-319-32700-6_18-1
  6. Chung KT, Shelat VG. Perforated peptic ulcer – an update. World J Gastrointest Surg. 2017;9(1):1–12. https://doi.org/10.4240/wjgs.v9.i1.1
  7. Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician. 2008;77(7):971–8.
  8. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015;386(10000):1278–87. https://doi.org/10.1016/S0140-6736(15)00275-5
  9. Simillis C, Symeonides P, Shorthouse AJ, Tekkis PP. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis. Surgeon. 2010;8(2):88–98. https://doi.org/10.1016/j.surge.2009.11.001
  10. Weinandt WM. Appendicitis is a severe disease in elderly patients: a twenty-year audit. JSLS. 2020;24(3):e2020.00046. https://doi.org/10.4293/JSLS.2020.00046
  11. World Health Organization. Definition of an older or elderly person [Internet]. Geneva: WHO; 2017
  12. Ferris M, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The global incidence of appendicitis: a systematic review of population-based studies. Ann Surg. 2017;266(2):237–41. https://doi.org/10.1097/SLA.0000000000002188
  13. Cervellin G, Mora R, Ticinesi A, Meschi T, Comelli I, Catena F, et al. Epidemiology and outcomes of acute abdominal pain in a large urban emergency department: retrospective analysis of 5,340 cases. Ann Transl Med. 2016;4(19):362. https://doi.org/10.21037/atm.2016.09.10
  14. Abdulla AH. Acute abdomen: comparative study in the elderly and young age groups [Fellowship thesis]. Baghdad: Iraqi Board for Medical Specializations in General Surgery; 2018.
  15. Andersson RE. The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of pre-hospital perforations imply that a correct diagnosis is more important than an early diagnosis. World J Surg. 2007;31(1):86–92. https://doi.org/10.1007/s00268-006-0466-6
  16. Smith DA, Kashyap S, Nehring SM. Bowel obstruction. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 [cited 2024 Oct 10]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441975/
  17. Halabi WJ, Kang CY, Ketana N, Nguyen VQ, Carmichael JC, Pigazzi A, et al. Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Ann Surg. 2014;259(2):329–35. https://doi.org/10.1097/SLA.0b013e31827eefed
  18. Martin V, Berrada D, Montravers P, Tresallet C, Abback PS, de Tymowski C, et al. Comparison of attributes between young and old patients who died in hospital after bowel obstruction: a multicentre retrospective cohort study. Surgery Open Digestive Advance. 2024;16:100283. https://doi.org/10.1016/j.sodab.2024.100283
  19. Laurell H, Hansson LE, Gunnarsson U. Acute abdominal pain among elderly patients. Gerontology. 2006;52(6):339–44. https://doi.org/10.1159/000094982
  20. Sanson TG, O'Keefe KP. Evaluation of abdominal pain in the elderly. Emerg Med Clin North Am. 1996;14(3):615–27. https://doi.org/10.1016/S0733-8627(05)70273-X
  21. Flasha MH, Goldberg E. Acute abdominal pain. Med Clin N Am. 2006;90:481–503. https://doi.org/10.1016/j.mcna.2005.11.005
  22. Zhao D, Wang Y, Wong N, Wang J, Chen Y. Impact of aging on cardiovascular diseases: from chronological observation to biological insights. JACC Asia. 2024;4(5):345–58. https://doi.org/10.1016/j.jacasi.2024.02.003
  23. Zhou M, Zhao G, Zeng Y, Chen X, Zheng L, Chen C, et al. Aging and cardiovascular disease: current status and challenges. Rev Cardiovasc Med. 2022;23(4):135. https://doi.org/10.31083/j.rcm2304135
  24. Ballinger A, Patchett S. Clinical Gastroenterology. 3rd ed. Oxford: Oxford University Press; 2018.
  25. Krause WR, Webb T. Geriatric small bowel obstruction: an analysis of treatment and outcomes compared with a younger cohort. Am J Surg. 2015;209(2):347–51. https://doi.org/10.1016/j.amjsurg.2014.08.027
  26. Ozturk G, Aydinli B, Atamanalp SS, Yildirgan MI, Basoglu M, Oren D. Acute mesenteric ischemia in young adults. Wien Med Wochenschr. 2012;162(15–16):349–53. https://doi.org/10.1007/s10354-012-0111-8
  27. Wilkins Gamiz A, Varela-Rueda CE, Blasco y González JM. Morbidity and mortality in patients presenting with acute abdominal pain. Rev Gastroenterol Mex. 1989;54(4):223–9.
  28. Dare AJ, Ng-Kamstra JS, Patra J, Liu L, Weiser TG, Fuglsang S, et al. Deaths from acute abdominal conditions and geographical access to surgical care in India: a nationally representative spatial analysis. Lancet Glob Health. 2015;3(10):e646–53. https://doi.org/10.1016/S2214-109X(15)00079-3

Similar Articles

You may also start an advanced similarity search for this article.