آپانديسيت حاد در سالمندان

Acute Appendicitis in Elderly Patients.

Introduction & Objective: The acute appendicitis in the elderly is associated with high morbidity and mortality rates. Moreover, clinical manifestations might be different in these patients. The aim of this study was assessment of clinical manifestations, diagnostic problems, morbidity, and mortality among patients aged 55 or above, in Loghman Hakim hospital from 1997- 2004. Materials & Methods: In this descriptive study we evaluated registries of patients with history of appendectomy aged 55 or above. Results: During this period 1843 appendectomies had been registered in Loghman Hakim hospital. 97 cases were 55 year-old or older [58 male/ 39 female]. 50 cases presented with atypical appendicitis. The mean delay between initiation of pain and appendectomy was 56.38 hours. The surgical incision was midline in 51 cases. Early complications were detected in 28 patients. 50 patients had advanced appendicitis. None of the patients had appendicular neoplasm. Two patients who died had a sever cardiovascular co morbid condition prior to developing acute appendicitis. Two patients who died, one with history of congestive heart failure, and another with recent myocardial infarction. Conclusions: In all old Patients who presented with acute abdominal pain, the diagnosis of acute appendicitis, have to be kept in mind.