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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2004 December;17(6):219-22
What has changed in the management of acute appendicitis in the elderly?
Eryilmaz R., Sahin M., Alimoglu O.
Aim. Although 5-10% of all cases of acute appendicitis occur in the elderly, over 50% of deaths due to acute appendicitis are observed in these patients. Personal clinical experience in elderly patients who were operated on acute appendicitis and the improvement in the treatment and outcome are reviewed.
Methods. We analyzed medical records of 74 patients over 60 years of age who were operated on for acute appendicitis from January 1991 to January 2003 in our Clinic have been analyzed Patients'age, sex, clinical signs and symptoms, laboratory and radiological studies, histopathological results, complications, and length of hospital stay were evaluated.
Results. There were 40 men (54%) and 34 women (46%). The rate of elderly patients among cases of acute appendicitis was 3.37%. Mean age was 67 and perforation rate was 58%. Duration of symptoms was more than 48 h in 25 of the patients. In hospital delay to surgery was less than 24 h in 60 of the patients. Atypical cases were associated with high perforation rates, and the rate of perforation was increased in patients with delay in admission to the hospital.
Conclusion. The incidence of perforated appendicitis is high in elderly patients, and atypical clinical presentation causes difficulty in diagnosis. Acute appendicitis in the elderly is still a significant problem for both diagnosis and treatment, despite improvement in imaging methods and care.