Acute Abdomen as a Cause of Death in Sudden,Unexpected Deaths in the Elderly

Abstract

Aims

This study profiles patients aged 70 years or above dying suddenly of an ‘acute abdomen’ and investigates the specific features associated with the conditions and their diagnoses.

Methods

A retrospective study using data obtained from autopsy and police reports held in the Forensic Medicine Section of the University of Edinburgh.

Results

From 1997 to 2000, out of 2121 autopsies of patients aged 70 or above, an ‘acute abdomen’ was considered as a primary cause of death in 111 cases. The number of cases increased over the period of study. Peptic ulcer disease was the commonest underlying cause of death. Twenty-nine (26.1%) cases were due to its complications, namely gastrointestinal haemorrhage and perforation. Sixty-nine (62.2%) patients were seen by a medical practitioner in circumstances arising from the onset of acute abdomen. In 27 (39.1%) cases a provisional diagnosis was recorded.

Conclusion

The ‘acute abdomen’ is still an appreciably frequent cause of death in sudden, unexpected deaths in the older age group. Some of the deaths may have been preventable with an early diagnosis. A high level of vigilance and early attention to an ‘acute abdomen’ by medical practitioners is therefore advocated.