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[Acute appendicitis in aged patients].

R Pricolo1, F Voltolini, P Croce

  • 1Ospedale Civile, Casalpusterlengo, Milano.

Minerva Chirurgica
|March 15, 1991
PubMed
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Elderly patients over 50 with acute appendicitis experienced higher rates of appendix perforation (47.5%) and postoperative complications (27%) compared to younger groups. This highlights the aggressive nature of appendicitis in older adults.

Area of Science:

  • Surgery
  • Geriatric Medicine
  • Gastroenterology

Background:

  • Acute appendicitis is a common surgical emergency.
  • Age significantly impacts disease presentation and outcomes in appendicitis.

Purpose of the Study:

  • To compare the clinical presentation, surgical outcomes, and complication rates of acute appendicitis in elderly patients (over 50) versus younger age groups.
  • To identify risk factors and specific challenges associated with appendicitis in the geriatric population.

Main Methods:

  • Retrospective analysis of 40 patients over 50 with acute appendicitis (Group I) operated between 1977-1989.
  • Comparison with two control groups: Group II (21-50 years) and Group III (1-20 years).
  • Data collected included symptom-to-admission intervals, operative details, hospital stay, morbidity, and mortality.

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Main Results:

  • The elderly group (Group I) showed a significantly higher incidence of perforated appendices (47.5%) compared to younger groups.
  • Postoperative complication rates were substantially higher in Group I (27%) versus Group II (7.5%) and Group III (2.5%).
  • Wound infection (44%) and prolonged ileus (15%) were the most frequent complications in elderly patients with perforated appendicitis.

Conclusions:

  • Acute appendicitis presents more aggressively in patients over 50, leading to increased perforation and complication rates.
  • Delayed diagnosis or more aggressive disease progression may contribute to poorer outcomes in the elderly.
  • Surgical management of appendicitis in older adults requires careful consideration of age-related risks and potential complications.