The diagnosis and treatment of acute appendicitis in the aged

Smithy, William B.; Wexner, Stevend D.; Dailey, Thomas H.

doi:10.1007/bf02555015

Cited by 32 publications

(22 citation statements)

References 7 publications

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“…Delay in presentation was found by many authors to be the reason behind the higher rate of perforation seen in the elderly population [2,3,6,7,13,15-17]. Our study showed that perforation rate correlated well with delayed presentation (pre-hospital delay) but did not correlate with the in-hospital delay.…”

Section: Discussionsupporting

confidence: 44%

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Acute appendicitis in the elderly: risk factors for perforation

et al. 2014

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BackgroundAcute appendicitis is the most common surgical emergency and becomes serious when it perforates. Perforation is more frequent in the elderly patients. The aim of this study was to identify the risk factors of perforation in elderly patients who presented with acute appendicitis.MethodologyThe medical records of 214 patients over the age of 60 years who had a pathologically confirmed diagnosis of acute appendicitis over a period of 10 years (2003-2013) were retrospectively reviewed. Patients were grouped into those with perforated and those with nonperforated appendicitis. Comparison was made between both groups in regard to demography, clinical presentation, and time delay to surgery, diagnosis, hospital stay and postoperative complications. Clinical assessment, Ultrasonography and Computerized tomography, in that order, were used for diagnosis. The incidence of perforation was also compared with a previous report from the same region 10 years earlier.ResultsDuring the study period, a total of 214 patients over the age of 60 years had acute appendicitis, 103 males and 111 females. Appendix was found perforated in 87 (41%) patients, 46 (53%) males and 41 (47%) females. Of all patients, 31% were diagnosed by clinical assessment alone, 40% needed US and 29% CT scan. Of all the risk factors studied, the patient’s pre-hospital time delay was the most important risk factor for perforation. Perforation rate was not dependent on the presence of comorbid diseases or in-hospital time delay. Post operative complications occurred in 44 (21%) patients and they were three times more common in the perforated group, 33 (75%) patients in the perforated and 11 (25%) in the nonperforated group. There were 6 deaths (3%), 4 in the perforated and 2 in the nonperforated group.ConclusionAcute appendicitis in elderly patients is a serious disease that requires early diagnosis and treatment. Appendiceal Perforation increases both mortality and morbidity. All elderly patients presented to the hospital with abdominal pain should be admitted and investigated. The early use of CT scan can cut short the way to the appropriate treatment.

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Section: Discussionsupporting

confidence: 44%

“…As compared to younger age group, elderly patients have more underlying diseases and sluggish bodily physiological reactions resulting in a higher rate of morbidity and mortality [1,2]. …”

Section: Introductionmentioning

confidence: 99%

Acute appendicitis in the elderly: risk factors for perforation

et al. 2014

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“…2,3,17,26 In the present study, the mean age was around 30 years. This was similar to other studies.…”

Section: Discussionmentioning

confidence: 49%

Risk factors of acute and perforated appendicitis in a semi-rural population: a retrospective study

Paidipelly

Sangamitra²

2018

Int Surg J

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Background: Acute appendicitis is one of the common conditions observed in the surgery department, which requires an emergency appendectomy with complicated appendicitis including perforated appendicitis is a cause of great concern involving severe morbidity and mortality. To improve our understanding of the sign and symptoms as well as the clinical findings of appendectomy, both in perforated and non-perforated appendicitis, this study was conducted retrospectively on the –patients who attended our hospital.Methods: T The demographic details of 184 the patients in this retrospective study were noted such as age, sex, weight and height, socioeconomic status, the sign and symptoms of the illness at the time of admission, time taken for the surgery to be performed after the admission was noted. All the investigations details such as random blood sugar, complete blood picture, hemoglobin, radiological findings abdominopelvic CT scan where necessary were also noted.Results: Out of the 184 patients admitted to our hospital for appendectomy 22% had perforated appendicitis and 78% had uncomplicated nonperforated appendicitis. The mean age of all the patients in the no perforated group was 30 ± 8.3 and 33±10.2 among the perforated group, with males being more affected than females. The most common symptom among all the patients was migrating pain in the abdomen, followed by anorexia, fever and vomiting. There was a greater time lapse between the onset of symptoms to the admission time in the patients with perforated appendicitis (4.9±1.6 days), compared to the non-perforated cases (2.4±1.8 days), with longer hospital stay and raised WBC counts.Conclusions: Proper education regarding the health and well-being of a patient of any age group should properly be given to the patient and their approach to the hospital at the earliest must be reiterated.

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“…Once admitted, a considerable further delay of operative treatment is also noted. Several studies confirm that postadmission delay is a major contributor to unfavorable outcomes in older patients with appendicitis [5,6,7,8,12,15,16,17,18].…”

Section: Discussionmentioning

confidence: 96%

Acute appendicitis in late adulthood: incidence, presentation, and outcome. Results of a prospective multicenter acute abdominal pain study and a review of the literature

Kraemer

Franke

Ohmann

et al. 2000

Langenbeck's Archives of Surgery

109

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Appendicitis in late adulthood is characterized by a delay in treatment, high perforation rates, and unfavorable outcome parameters, all mutually correlating. Older patients with acute abdominal pain are high-risk patients, unlike their younger counterparts. They have to be clinically evaluated by experienced surgeons within a narrow time margin. The problem of late presentation and/or referral should be addressed, perhaps by education of primary care physicians and the public.

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The diagnosis and treatment of acute appendicitis in the aged

Cited by 32 publications

References 7 publications

Acute appendicitis in the elderly: risk factors for perforation

Acute appendicitis in the elderly: risk factors for perforation

Risk factors of acute and perforated appendicitis in a semi-rural population: a retrospective study

Acute appendicitis in late adulthood: incidence, presentation, and outcome. Results of a prospective multicenter acute abdominal pain study and a review of the literature

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