Balsano N, Cayten C G
New York Medical College.
Emerg Med Clin North Am. 1990 May;8(2):399-410.
Abdominal emergencies in the elderly requiring emergent surgery pose a significant challenge to the emergency physician. Because of concomitant illness, these patients generally have a substantial operative risk. Further, the symptoms and signs in these patients are frequently milder and less specific than in younger adults with the same conditions. Therefore, the emergency physician must develop a high index of suspicion for these conditions and must seek early surgical consultation, even if a definitive diagnosis has not been established. In other words, in many cases consultation must be sought on the basis of the emergency physician's clinical suspicion rather than on "hard" data. Emergency physicians must pay particular attention to associated extra-abdominal disease, which must be diagnosed and stabilized to minimize the risk of emergent surgery. Only aggressive assessment, expeditious resuscitation, and team work with the surgical consultants can minimize the high mortality rate associated with these acute abdominal surgical emergencies.
老年患者发生需要急诊手术的腹部急症，这给急诊医生带来了巨大挑战。由于存在合并症，这些患者通常手术风险很大。此外，与患有相同病症的年轻成年人相比，这些患者的症状和体征往往更轻微、更不具特异性。因此，急诊医生必须对这些病症保持高度的怀疑指数，即使尚未确立明确诊断，也必须尽早寻求外科会诊。换句话说，在许多情况下，必须基于急诊医生的临床怀疑而非“确凿”数据来寻求会诊。急诊医生必须特别关注相关的腹外疾病，必须对其进行诊断并使其稳定，以尽量降低急诊手术的风险。只有积极评估、迅速复苏以及与外科会诊医生团队协作，才能将与这些急性腹部外科急症相关的高死亡率降至最低。
