Appendicitis in older African patients: 10 year review and report of 84 cases

Appendicitis in the aged patient is uncommon even in developed countries although it is now more frequently seen and treated. A review of 84 patients aged between 40 and 80 years and who had appendicectomy for appendicitis in a sub-Saharan hospital is presented. The study covered the 10 years January 1982 to December 1991. This number constituted 8.1 pc of the total appendicectomies for appendicitis. There were 59 males and 25 females with a cluster of appendicitis between the ages of 40 and 50 years forming 85.7 pc. The mean age was 52.2 pc years and the females tended to be younger. Only five patients constituting of 0.5 pc of total appendicectomies performed in the study period were aged 60 years and above. The presentation was only classical the nearer the ages of the patients were to 40 years. The only reliable clinical parameter was an area of maximal tenderness in the right iliac fossa at McBurney's point which was present in 70 patients (83.3 pc). The diagnostic accuracy rate as confirmed by histological reports was only 60.7 pc as opposed to clinical and peri-operative diagnoses of 70 (83.3 pc) and 90 pc respectively. Five of the inflamed appendices were suppurative, four perforated and one gangerous, thus only about 12 pc of the appendices were potentially catastrophic. There was no death.