INTRODUCTION: Population aging is a significant medico-social problem that remains relevant today and still lacks a sufficiently adequate solution. This is due to the complex influence of numerous factors on people's health, as well as increased morbidity and mortality from both common and relatively rare diseases.
AIM: The aim of this article is to define the features of subjective complaints, physical findings, diagnostic possibilities, and the course and outcome of acute pancreatitis in elderly patients.
MATERIAL AND METHODS: The subject of the present study includes 29 patients with acute pancreatitis, hospitalized on an emergency basis and operated on in the Second Department of Surgery at the Clinic of Surgical Diseases, at St. Marina University Hospital - Varna. All hospitalized patients underwent routine clinical, laboratory, and imaging tests. The following statistical methods were used for analysis and interpretation of the obtained data: alternative analysis, variation analysis, correlation analysis, and univariate logistic regression analysis.
RESULTS: A constellation of indicators characterizes some of the key peculiarities in the diagnosis and treatment of these patients, with an emphasis on the role of General Practitioners, aiming to increase efficiency and improve the quality of medical care for this specific population.
CONCLUSION: The clinical presentation of acute pancreatitis in the elderly differs from the typical form. A sudden onset with low-intensity epigastric pain and vomiting is crucial in diagnosing the disease.
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