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Published on: August 24, 2019
[Acute appendicitis in patients over 70 years of age]
1Service de Chirurgie générale, digestive et vasculaire, Hôpital Ambroise Paré, Boulogne-Billancourt.
Objectives:
We assessed preoperative diagnosis of appendicitis and perforations in elderly patients in our unit to determine whether the overall higher rate of appendectomy in France (3 to 4 times higher than in anglo-saxon countries) has an effect.
Methods:
We analyzed retrospectively the cases of all patients over 70 years of age who undervent appendectomy for histologically confirmed appendicitis between February 1, 1990 and 31 January 1995.
Results:
There were 20 patients (15 women 5 men) in the study group (age range 70-89 years). The site of abdominal pain was atypical in 10 cases (50%) and acute bowel occlusion occurred in 9 (45%). The diagnosis of appendicitis was made before surgery in 10 patients; surgery was performed within 24 hours of admission in only 8. The high rate of perforations (70%) was not correlated with age. Complications occurred in 70% of the cases and were related to perforation (p < 0.02) and an American Society of Anesthesia (ASA) score > 2 (p < 0.05).
Conclusion:
Acute appendicitis in the elderly patient is a serious condition. The atypical nature of the clinical presentation in half of the patients often requires computed tomography or laparoscopy for diagnosis.
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Appendicitis
