[Appendicitis in the aged]

Peculiarities relating to appendicitis in advanced age are described in this paper, with reference being made to a prospective study conducted in 1982 into acute abdominal processes. Covered by that study were 545 patients with acute abdominal symptoms. Reference was also made to an evacuation of 890 cases of appendectomy performed between 1983 and 1985. Appendicitis was found to be relatively rare in advanced age and accounted for merely seven per cent of all appendectomies. Frequent reports on increased perforation rates in advanced age were confirmed by the authors' own findings. Presurgical diagnostic accuracy was between 70 and 75 per cent, relative to the surgeon's visual intra-operative findings. The assumption has to be made that in 25 to 30 per cent of all appendectomies the vermiform appendix processus is removed without detection of any acute inflammation. In patients in advanced age, particular attention should be given to renal and urinary tract findings with complaints that might encourage falsely positive indications for laparotomy.