Elderly versus young patients with appendicitis 3 years experience

Abstract

Background: Appendicitis in the elderly continues to be a challenging surgical problem. Patients continued to present late with atypical presentations. Results might improve with earlier consideration of the diagnosis in elderly patients with abdominal pain, followed by prompt surgical operation. We aimed to present our experience with a series of elderly patients with acute appendicitis who were subjected to appendectomy to find out the difference in the course and outcome of
acute appendicitis in elderly patients.
Patients and methods: We reviewed medical records of elderly patients (aged >60 years) who underwent appendectomy for acute appendicitis at our hospital. Variables selected for analysis included age, sex, presenting symptoms, operative approach, operative findings, duration of hospitalization. Patients were compared to a control group, less than 31 years admitted during the same period.
Results: Twenty-three patients’ records aged > 60 years with acute appendicitis were compared to a group of 40 patients aged< 30 years. There were significant differences between the two groups with regard to duration of symptoms preoperative hospital stay and total hospital stay. All young patients group had an uneventful postoperative recovery only two cases (5%) had wound infection. There was one death in the elderly group thus mortality rate was 4.3%. These two groups of patients showed significant differences in relation to the stage of disease at operation and postoperative complications. Elderly group of patients had perforated appendix in 16 cases (69.5%) while in group II patients eight cases (20%) had perforated appendix

Conclusion: Acute appendicitis in the elderly remains a challenge for practicing surgeons and continues to be associated with high morbidity and mortality. Results might improve with earlier consideration of the use of CT abdomen for diagnosis in elderly patients with abdominal pain, followed
by prompt surgical operation.