5, 19, 30 Elevated serum amylase and leukocytosis can develop quickly with perforation caused by pancreatic amylase spilling into the peritoneal cavity. Up to one third of patients with peptic ulcer disease do not have any pain, particularly among those taking NSAIDs. Abdominal pain with a perforation classically occurs with an abrupt onset, is located in the epigastrium, presents with absent bowel sounds, and is associated with abdominal rigidity. 30 Often, the first sign of the disease is with an acute complication, such as perforation. Symptoms of peptic ulcer disease are usually absent or vague and poorly localized approximately 30 percent of patients older than 60 years with confirmed peptic ulcer disease have no abdominal pain. Morbidity and mortality among older patients presenting with acute abdominal pain are high, and these patients often require hospitalization with prompt surgical consultation. Small and large bowel obstructions, usually caused by adhesive disease or malignancy, are more common in the aged and often require surgery. Diverticulitis is a common cause of abdominal pain in the older patient in appropriately selected patients, it may be treated on an outpatient basis with oral antibiotics. Medication use, gallstones, and alcohol use increase the risk of pancreatitis, and advanced age is an indicator of poor prognosis for this disease. In older patients with appendicitis, the initial diagnosis is correct only one half of the time, and there are increased rates of perforation and mortality when compared with younger patients. Changes that occur in the biliary system because of aging make older patients vulnerable to acute cholecystitis, the most common indication for surgery in this population. The physical examination can be misleadingly benign, even with catastrophic conditions such as abdominal aortic aneurysm rupture and mesenteric ischemia. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. Dine beside Paolozzi’s gigantic Vulcan sculpture and treat yourself to fresh, seasonal Italian inspired dishes with a Scottish twist.Acute abdominal pain is a common presenting complaint in older patients. Modern Two also benefits from housing restaurant Paolozzi’s Kitchen, named after the Scottish artist Eduardo Paolozzi. The gallery building looks out over sculptural works by Dan Graham and Nathan Coley, which do more than just add to the stunning parkland scenery. Modern Two is located across the road from Modern One and sits atop its own expansive green space. Take a journey through experimentation, abstraction, and mind-bending creative explorations. Modern Two’s collection of intriguing artworks shows the departure from traditional styles, in search of new forms and expressions emerging in the late 19th and early 20th century. Once you are done delving into the art on display both outdoors and in, you can re-energise at the wonderful Cafe Modern One, famous for its legendary scones. Explore the grounds and discover further sculptural works by other major artists. On arrival at Modern One you will be in awe of the striking land feature in front of the gallery designed by landscape architect Charles Jencks. Get ready for captivating, light-hearted and all-encompassing experiences. Discover displays, shows and installations from the leading artists of today. Brace yourself for a sensory rollercoaster. Weave your way through two exciting gallery spaces featuring leading artists' works which define the Modern era. You will find the many artworks on display to be playful, thought provoking and compelling. One site, two sculpture parks, two galleries and lots for you to discover.
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