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[Acute appendicitis in the elderly patient].

J A Monzón Abad1, M J Redondo Lázaro, P A Osta Cornago

  • 1Servicio de Cirugía General, Hospital del Insalud, Soria.

Revista Espanola De Enfermedades Digestivas
|November 1, 1991
PubMed
Summary

Delayed diagnosis of acute appendicitis in elderly patients significantly increases morbidity. Early appendectomy is crucial for reducing complications in this vulnerable population.

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Area of Science:

  • Geriatric Medicine
  • Surgical Pathology
  • Emergency Medicine

Background:

  • Acute appendicitis is a common surgical emergency.
  • Elderly patients present unique diagnostic and management challenges.
  • Appendicitis in older adults can lead to higher morbidity and mortality.

Purpose of the Study:

  • To evaluate the diagnostic delay and outcomes of acute appendicitis in patients over 65 years old.
  • To determine the factors contributing to high morbidity in this age group.
  • To assess the rate of perforated appendicitis and its relation to diagnostic timelines.

Main Methods:

  • Retrospective analysis of 55 patients aged over 65 undergoing appendectomy for suspected acute appendicitis.
  • Histological examination to confirm appendicitis and assess appendix normality.

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  • Review of clinical history to determine diagnostic delay (time from symptom onset to surgery).

    • Main Results:

    • Out of 55 patients, 49 (89.1%) had confirmed acute appendicitis after histology.
    • A significant diagnostic delay was observed: >24 hours in 63.2% and >48 hours in 34.6% of cases.
    • A high rate of perforated appendicitis (36.7%) was found, strongly correlated with prolonged symptom duration.

    Conclusions:

    • Delayed diagnosis and surgical intervention are major contributors to the high morbidity of acute appendicitis in elderly patients.
    • Prompt appendectomy is essential to mitigate complications and improve outcomes in geriatric appendicitis cases.
    • While perforated appendicitis is common, the study did not show an increased rate of early perforations in this specific elderly cohort compared to general appendicitis populations.