If an elderly patient is confused and exhibits a cool abdomen, which condition should be suspected?

The confusion and cool abdomen exhibited by an elderly patient strongly suggest hypothermia. In hypothermia, the body's core temperature drops to dangerously low levels, which can lead to confusion and disorientation as the body's normal functioning is impaired. A cool abdomen is a significant indicator, as it reflects the body's inability to maintain warmth, particularly in older adults, who may already have compromised thermoregulation.

Hypothermia can occur even in mildly cold weather or in environments where the patient is exposed to wind or rain, especially if they are dressed inadequately. The symptoms, including confusion and a cooler body temperature in specific areas like the abdomen, highlight the critical need for prompt assessment and intervention, including rewarming.

In contrast, conditions like heat exhaustion, dehydration, and hyperthermia are typically associated with elevated body temperatures and may present with different symptoms such as sweating, weakness, or skin that is hot to the touch, which does not align with the signs observed in this patient. Therefore, the presentation of confusion alongside a cool abdomen is most consistent with hypothermia.