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Appendicitis is common in older adults presenting with lower abdominal pain. Delays in diagnosis and treatment, particularly in hospital settings, contribute to complications like perforation in this age group.
Area of Science:
- Gastroenterology
- Emergency Medicine
- Geriatric Medicine
Background:
- Appendicitis is a frequent cause of undiagnosed lower abdominal pain across all age groups.
- Older patients presenting with abdominal pain require careful evaluation to rule out appendicitis.
Purpose of the Study:
- To estimate the incidence of appendicitis in patients over 40.
- To establish the clinical profile and diagnostic challenges of appendicitis in older individuals.
Main Methods:
- Retrospective review of 616 patient charts from a community hospital emergency department.
- Analysis focused on patients aged 40 and above presenting with lower abdominal pain.
Main Results:
- Appendicitis presented commonly in older patients, similar to younger demographics.
- Significant pre-operative delays, leading to perforation, often occurred within the hospital.
- Barium enema proved to be a safe and effective diagnostic tool in 22 cases.
Conclusions:
- Appendicitis is a prevalent condition in older adults with lower abdominal pain.
- In-hospital delays are a critical factor in appendiceal perforation among this demographic.
- Diagnostic imaging, such as barium enema, can aid in timely diagnosis.
Abstract:
Charts of 616 patients over the age of 40 presenting to a community hospital emergency department with lower abdominal pain were reviewed to estimate the incidence and establish the profile of appendicitis in older patients. Appendicitis remains the commonest cause of undiagnosed lower abdominal pain, and retains a common presentation at all ages. Much of the pre-operative delay in patients who perforated appendices occurred in the hospital. Barium enema was a useful and safe diagnostic procedure used in 22 cases.